Trajectory of post-COVID brain fog, memory loss, and concentration loss in previously hospitalized COVID-19 survivors:the LONG-COVID-EXP multicenter study

OBJECTIVE: This study aimed to apply Sankey plots and exponential bar plots for visualizing the trajectory of post-COVID brain fog, memory loss, and concentration loss in a cohort of previously hospitalized COVID-19 survivors.METHODS: A sample of 1,266 previously hospitalized patients due to COVID-19 during the first wave of the pandemic were assessed at 8.4 (T1), 13.2 (T2), and 18.3 (T3) months after hospital discharge. They were asked about the presence of the following self-reported cognitive symptoms: brain fog (defined as self-perception of sluggish or fuzzy thinking), memory loss (defined as self-perception of unusual forgetfulness), and concentration loss (defined as self-perception of not being able to maintain attention). We asked about symptoms that individuals had not experienced previously, and they attributed them to the acute infection. Clinical and hospitalization data were collected from hospital medical records.RESULTS: The Sankey plots revealed that the prevalence of post-COVID brain fog was 8.37% (n = 106) at T1, 4.7% (n = 60) at T2, and 5.1% (n = 65) at T3, whereas the prevalence of post-COVID memory loss was 14.9% (n = 189) at T1, 11.4% (n = 145) at T2, and 12.12% (n = 154) at T3. Finally, the prevalence of post-COVID concentration loss decreased from 6.86% (n = 87) at T1, to 4.78% (n = 60) at T2, and to 2.63% (n = 33) at T3. The recovery exponential curves show a decreasing trend, indicating that these post-COVID cognitive symptoms recovered in the following years after discharge. The regression models did not reveal any medical record data associated with post-COVID brain fog, memory loss, or concentration loss in the long term.CONCLUSION: The use of Sankey plots shows a fluctuating evolution of post-COVID brain fog, memory loss, or concentration loss during the first years after the infection. In addition, exponential bar plots revealed a decrease in the prevalence of these symptoms during the first years after hospital discharge. No risk factors were identified in this cohort.</p

Associated-Onset Symptoms and Post-COVID-19 Symptoms in Hospitalized COVID-19 Survivors Infected with Wuhan, Alpha or Delta SARS-CoV-2 Variant

This study compared associated-symptoms at the acute phase of infection and post-COVID-19 symptoms between individuals hospitalized with the Wuhan, Alpha or Delta SARS-CoV-2 variant. Non-vaccinated individuals hospitalized because of SARS-CoV-2 infection in one hospital during three different waves of the pandemic (Wuhan, Alpha or Delta) were scheduled for a telephone interview. The presence of post-COVID-19 symptoms was systematically assessed. Hospitalization and clinical data were collected from medical records. A total of 201 patients infected with the Wuhan variant, 211 with the Alpha variant and 202 with Delta variant were assessed six months after hospitalization. Patients infected with the Wuhan variant had a greater number of symptoms at hospital admission (higher prevalence of fever, dyspnea or gastrointestinal problems) than those infected with Alpha or Delta variant (p < 0.01). A greater proportion of patients infected with the Delta variant reported headache, anosmia or ageusia as onset symptoms (p < 0.01). The mean number of post-COVID-19 symptoms was higher (p < 0.001) in individuals infected with the Wuhan variant (mean: 2.7 ± 1.3) than in those infected with the Alpha (mean: 1.8 ± 1.1) or Delta (mean: 2.1 ± 1.5) variant. Post-COVID-19 dyspnea was more prevalent (p < 0.001) in people infected with the Wuhan variant, whereas hair loss was higher in those infected with the Delta variant (p = 0.002). No differences in post-COVID-19 fatigue by SARS-CoV-2 variant were found (p = 0.594). Differences in COVID-19 associated onset symptoms and post-COVID-19 dyspnea were observed depending on the SARS-CoV-2 variant. The presence of fatigue was a common post-COVID-19 symptom to all SARS-CoV-2 variants

Prevalence of Musculoskeletal Post-COVID Pain in Hospitalized COVID-19 Survivors Depending on Infection with the Historical, Alpha or Delta SARS-CoV-2 Variant

We compared the prevalence of musculoskeletal post-COVID pain between previously hospitalized COVID-19 survivors infected with the historical, Alpha or Delta SARS-CoV-2 variant. Data about musculoskeletal post-COVID pain were systematically collected through a telephone interview involving 201 patients who had survived the historical variant, 211 who had survived the Alpha variant and 202 who had survived the Delta variant six months after hospital discharge. Participants were recruited from non-vaccinated individuals hospitalized due to SARS-CoV-2 infection in one hospital of Madrid (Spain) during three different waves of the pandemic (historical, Alpha or Delta variant). Hospitalization and clinical data were collected from hospital medical records. In addition, anxiety/depressive levels and sleep quality were also assessed. The prevalence of musculoskeletal post-COVID pain was higher (p = 0.003) in patients infected with the historical variant (47.7%) than in those infected with the Alpha (38.3%) or Delta (41%) variants. A significantly (p = 0.002) higher proportion of individuals infected with the historical variant reported generalized pain (20.5%) when compared with those infected with the other variants. The prevalence of new-onset post-COVID musculoskeletal pain reached 80.1%, 75.2% and 79.5% of patients infected with the historical, Alpha or Delta variants, respectively. No specific risk factors for developing post-COVID pain were identified depending on the SARS-CoV-2 variant. In conclusion, this study found that musculoskeletal post-COVID pain is highly prevalent in COVID-19 survivors six months after hospital discharge, with the highest prevalence and most generalized pain symptoms in individuals infected with the historical variant. Approximately 50% developed “de novo” post-COVID musculoskeletal pain symptoms

Successful treatment of Candida parapsilosis mural endocarditis with combined caspofungin and voriconazole

BACKGROUND: Fungal mural endocarditis is a rare entity in which the antemortem diagnosis is seldom made. Seven cases of mural endocarditis caused by Candida spp. have been collected from literature and six of these patients died after treatment with amphotericin B. CASE PRESENTATION: We report a case of mural endocarditis diagnosed by transesophageal echocardiogram and positive blood cultures to Candida parapsilosis. Because blood cultures continued to yield C. parapsilosis despite caspofungin monotherapy, treatment with voriconazole was added. CONCLUSION: This is the first description of successful treatment of C. parapsilosis mural endocarditis with caspofungin and voriconazole

The state of the Martian climate

60°N was +2.0°C, relative to the 1981–2010 average value (Fig. 5.1). This marks a new high for the record. The average annual surface air temperature (SAT) anomaly for 2016 for land stations north of starting in 1900, and is a significant increase over the previous highest value of +1.2°C, which was observed in 2007, 2011, and 2015. Average global annual temperatures also showed record values in 2015 and 2016. Currently, the Arctic is warming at more than twice the rate of lower latitudes

Scientific and Technical Report of the DRAGO 0511 Oceanographic Cruise. Extension of the Spanish Continental Shelf west off Canary Island

Informe científico de la campaña y de los resultados preliminaresLa campaña DRAGO 0511 forma parte de los trabajos para la extensión de la plataforma continental española al oeste de las islas Canarias conforme a la Convención de Naciones Unidas sobre Derecho del Mar (CONVEMAR). Han participado un total de 19 científicos y técnicos, 4 investigadores del Instituto Español de Oceanografía (IEO) y 4 investigadores del Instituto Geológico y Minero de España (IGME) del Ministerio de Ciencia e Innovación, 2 investigadores de TRAGSA (para la Secretaría General del Mar) del Ministerio de Medio Ambiente, Medio Rural y Marino, y 6 hidrógrafos del Instituto Hidrográfico de la Marina (IHM) del Ministerio de Defensa, así como 5 estudiantes (2 de grado y 3 de postgrado) de la Facultad de Ciencias del Mar y Ambientales de la Universidad de Cádiz, y de la Facultad de Ciencias Geológicas (Titulación de Ingeniería Geológica) de la Universidad Complutense. El objetivo de esta campaña es la adquisición de los datos científicos necesarios para preparar la propuesta de ampliación de la plataforma continental española más allá de las 200 millas marinas del área situada al oeste de las Islas Canarias, conforme al artículo 76 de CONVEMAR. La información que se ha obtenido es fundamentalmente de batimetría multihaz y monohaz, perfiles de la velocidad del sonido, perfiles sísmicos de alta resolución, y muestreo de fondos principalmente mediante dragas de roca. Estos datos permitirán definir desde un punto de vista morfográfico, morfosedimentario y geológico, la región de la base del talud, así como llevar a cabo la localización de los posibles pies de talud (FOS) en esta región,y demostrar la estrecha relación existente entre la zona estudiada y el archipiélago de las Islas Canarias. En este sentido se han estudiado de forma preferente un conjunto de montes submarinos presentes al suroeste de las islas Canarias cuya génesis, de origen magmático, se debe encontrar en los mismos procesos de “punto caliente” que probablemente han debido generar los edificios volcánicos que constituyen las propias islas Canarias. Por otro lado, se ha localizado la presencia de grandes cuerpos sedimentarios constituidos por materiales procedentes de estos montes submarinos y generados por movimientos en masa de tipo gravitacional a favor de la pendiente del talud continental. La presencia tanto de estos montes submarinos, como de las grandes masas de sedimentos gravitacionales y, además la localización de escarpes en el talud, serán puntos clave de gran interés en esta región, siendo argumentos científicos válidos para demostrar la prolongación natural del territorio emergido del archipiélago canario así como para localizar los puntos del pie del talud continental. Durante la campaña DRAGO 0511 se han adquirido un total de 10895.4 km de registros con sonda multihaz EM302, sonda monohaz EA 600 y sonda paramétrica TOPAS PS 18. De dichas líneas, 9647.3 km se han realizado en las dos zonas de trabajo planificadas, 5603.2 km en la zona A y 4044.3 km en la zona B. En la zona A se ha cubierto un área total de 19996 km2 mientras que en la zona B la extensión ha sido de 13545 km2. En total se ha cubierto una extensión de 17795 km2 en el área de posible ampliación de la plataforma continental española. Por otra parte, cabe señalar que además 16471 km2 de líneas se han realizado dentro de la ZEE española del archipiélago canario, que se utilizarán, en algún caso, para demostrar la continuidad de estos cuerpos sedimentarios con las islas Canarias, y más adelante para la cartografía de este sector de la ZEE española. El resto de registros, 1151.5 km. corresponden a los tránsitos. En el total del tiempo de la campaña DRAGO 0511, un 70.5 % se ha trabajado sobre las zonas planificadas A y B localizadas sobre las áreas de ampliación de la plataforma continental española o sobre puntos concretos de la ZEE española que pueden ser utilizados para establecer los FOS, un 16.7 % en tránsitos sobre la ZEE española de las islas Canarias y un 7.1% de recalada en los puertos de Santa Cruz de Tenerife y de La Estaca de la Iila de El Hierro. Los datos obtenidos en la campaña DRAGO 0511 serán usados para elaborar la presentación del trazado del límite exterior de la plataforma continental de España más allá de las 200 millas marinas en el polígono del archipiélago de las islas Canarias conforme a la parte VI y el anexo II de CONVEMAR. Dicha presentación de datos e información científica se deberá realizar ante la Comisión de límites de la plataforma continental de la Organización de las Naciones Unidas en Nueva York, de conformidad con la CONVEMAR y con las directrices científico-técnicas de dicha Comisión, con anterioridad al 9 de mayo del año 2014.Ministerio de Asuntos Exteriores y Cooperación (MAEC), Instituto Español de Oceanografía (IEO) e Instituto Geológico y Minero de España (IGME) ambos del Ministerio de Investigación, Ciencia e Industria (MICINN), Instituo Hidrográfico de la Marina (IHM) del Ministerio de Defensa (MDEF) y Secretaria General del Mar del Ministerio de Medio Ambiente, Medio Rural y Marino (MARM). Acción Complementaria del Plan Nacional de I+D+i CTM2010-09496-

Clonal chromosomal mosaicism and loss of chromosome Y in elderly men increase vulnerability for SARS-CoV-2

The pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2, COVID-19) had an estimated overall case fatality ratio of 1.38% (pre-vaccination), being 53% higher in males and increasing exponentially with age. Among 9578 individuals diagnosed with COVID-19 in the SCOURGE study, we found 133 cases (1.42%) with detectable clonal mosaicism for chromosome alterations (mCA) and 226 males (5.08%) with acquired loss of chromosome Y (LOY). Individuals with clonal mosaic events (mCA and/or LOY) showed a 54% increase in the risk of COVID-19 lethality. LOY is associated with transcriptomic biomarkers of immune dysfunction, pro-coagulation activity and cardiovascular risk. Interferon-induced genes involved in the initial immune response to SARS-CoV-2 are also down-regulated in LOY. Thus, mCA and LOY underlie at least part of the sex-biased severity and mortality of COVID-19 in aging patients. Given its potential therapeutic and prognostic relevance, evaluation of clonal mosaicism should be implemented as biomarker of COVID-19 severity in elderly people. Among 9578 individuals diagnosed with COVID-19 in the SCOURGE study, individuals with clonal mosaic events (clonal mosaicism for chromosome alterations and/or loss of chromosome Y) showed an increased risk of COVID-19 lethality

The evolution of the ventilatory ratio is a prognostic factor in mechanically ventilated COVID-19 ARDS patients

Background: Mortality due to COVID-19 is high, especially in patients requiring mechanical ventilation. The purpose of the study is to investigate associations between mortality and variables measured during the first three days of mechanical ventilation in patients with COVID-19 intubated at ICU admission. Methods: Multicenter, observational, cohort study includes consecutive patients with COVID-19 admitted to 44 Spanish ICUs between February 25 and July 31, 2020, who required intubation at ICU admission and mechanical ventilation for more than three days. We collected demographic and clinical data prior to admission; information about clinical evolution at days 1 and 3 of mechanical ventilation; and outcomes. Results: Of the 2,095 patients with COVID-19 admitted to the ICU, 1,118 (53.3%) were intubated at day 1 and remained under mechanical ventilation at day three. From days 1 to 3, PaO2/FiO2 increased from 115.6 [80.0-171.2] to 180.0 [135.4-227.9] mmHg and the ventilatory ratio from 1.73 [1.33-2.25] to 1.96 [1.61-2.40]. In-hospital mortality was 38.7%. A higher increase between ICU admission and day 3 in the ventilatory ratio (OR 1.04 [CI 1.01-1.07], p = 0.030) and creatinine levels (OR 1.05 [CI 1.01-1.09], p = 0.005) and a lower increase in platelet counts (OR 0.96 [CI 0.93-1.00], p = 0.037) were independently associated with a higher risk of death. No association between mortality and the PaO2/FiO2 variation was observed (OR 0.99 [CI 0.95 to 1.02], p = 0.47). Conclusions: Higher ventilatory ratio and its increase at day 3 is associated with mortality in patients with COVID-19 receiving mechanical ventilation at ICU admission. No association was found in the PaO2/FiO2 variation

Strong floristic distinctiveness across Neotropical successional forests.

Forests that regrow naturally on abandoned fields are important for restoring biodiversity and ecosystem services, but can they also preserve the distinct regional tree floras? Using the floristic composition of 1215 early successional forests (<20 years) in 75 human-modified landscapes across the Neotropic realm, we identified 14 distinct floristic groups, with a between-group dissimilarity of 0.97. Floristic groups were associated with location, bioregions, soil pH, temperature seasonality, and water availability. Hence, there is large continental-scale variation in the species composition of early successional forests, which is mainly associated with biogeographic and environmental factors but not with human disturbance indicators. This floristic distinctiveness is partially driven by regionally restricted species belonging to widespread genera. Early secondary forests contribute therefore to restoring and conserving the distinctiveness of bioregions across the Neotropical realm, and forest restoration initiatives should use local species to assure that these distinct floras are maintained