Effect of viral storm in patients admitted to intensive care units with severe COVID-19 in Spain: a multicentre, prospective, cohort study

Background: The contribution of the virus to the pathogenesis of severe COVID-19 is still unclear. We aimed to evaluate associations between viral RNA load in plasma and host response, complications, and deaths in critically ill patients with COVID-19. Methods: We did a prospective cohort study across 23 hospitals in Spain. We included patients aged 18 years or older with laboratory-confirmed SARS-CoV-2 infection who were admitted to an intensive care unit between March 16, 2020, and Feb 27, 2021. RNA of the SARS-CoV-2 nucleocapsid region 1 (N1) was quantified in plasma samples collected from patients in the first 48 h following admission, using digital PCR. Patients were grouped on the basis of N1 quantity: VIR-N1-Zero ([removed]2747 N1 copies per mL). The primary outcome was all-cause death within 90 days after admission. We evaluated odds ratios (ORs) for the primary outcome between groups using a logistic regression analysis. Findings: 1068 patients met the inclusion criteria, of whom 117 had insufficient plasma samples and 115 had key information missing. 836 patients were included in the analysis, of whom 403 (48%) were in the VIR-N1-Low group, 283 (34%) were in the VIR-N1-Storm group, and 150 (18%) were in the VIR-N1-Zero group. Overall, patients in the VIR-N1-Storm group had the most severe disease: 266 (94%) of 283 patients received invasive mechanical ventilation (IMV), 116 (41%) developed acute kidney injury, 180 (65%) had secondary infections, and 148 (52%) died within 90 days. Patients in the VIR-N1-Zero group had the least severe disease: 81 (54%) of 150 received IMV, 34 (23%) developed acute kidney injury, 47 (32%) had secondary infections, and 26 (17%) died within 90 days (OR for death 0·30, 95% CI 0·16–0·55; p<0·0001, compared with the VIR-N1-Storm group). 106 (26%) of 403 patients in the VIR-N1-Low group died within 90 days (OR for death 0·39, 95% CI 0·26–0·57; p[removed]11 página

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

Calidad de cuidado materno: Una comparación entre bebés prematuros en cuidado madre canguro y bebés a término en cuidado regular

The purpose of this study was to examine the potential impact of an intervention program (Kangaroo Mother Care, KMC) on maternal sensitivity in a sample of high-risk adolescent mothers. Two mother-infant groups were compared: adolescent mothers with their preterm baby in kangaroo care and adolescent mothers with their full-term baby in regular care. Naturalistic observations at the home environment were conducted to assess maternal quality of care. No significant differences were found between both groups of dyads. Results are in line with the notion that KMC seems to play a protective role for adolescent mothers and their premature babies, given the additional risk factor of prematurity when compared to the full term group. These preliminary findings are stimulating and support further inquiry into the effects of KMC on maternal sensitivity particularly in high-risk populationsEl propósito de esta investigación fue estudiar los efectos de la intervención del Cuidado Madre Canguro (CMC) en la sensibilidad materna en una muestra de madres adolescentes con alto riesgo psicosocial. Se compararon dos grupos de díadas: madres adolescentes con bebés prematuros en cuidado madre canguro y madres adolescentes con bebés a término en cuidado regular. Se realizaron observaciones en el medio familiar para evaluar la calidad del cuidado materno. Los análisis indican que no existen diferencias significativas entre los dos grupos de madres adolescentes respecto a la calidad de cuidado materno. Este hallazgo permite suponer un efecto protector por parte del CMC en las díadas madres adolescente-bebé prematuros, ya que esta condición del bebé es un factor de riesgo adicional a las condiciones del grupo a término en cuidado regular. Estos resultados preliminares plantean la necesidad de continuar explorando los efectos de la intervención canguro en la sensibilidad materna especialmente en poblaciones vulnerable

Calidad de cuidado materno: Una comparación entre bebés prematuros en cuidado madre canguro y bebés a término en cuidado regular

The purpose of this study was to examine the potential impact of an intervention program (Kangaroo Mother Care, KMC) on maternal sensitivity in a sample of high-risk adolescent mothers. Two mother-infant groups were compared: adolescent mothers with their preterm baby in kangaroo care and adolescent mothers with their full-term baby in regular care. Naturalistic observations at the home environment were conducted to assess maternal quality of care. No significant differences were found between both groups of dyads. Results are in line with the notion that KMC seems to play a protective role for adolescent mothers and their premature babies, given the additional risk factor of prematurity when compared to the full term group. These preliminary findings are stimulating and support further inquiry into the effects of KMC on maternal sensitivity particularly in high-risk populationsEl propósito de esta investigación fue estudiar los efectos de la intervención del Cuidado Madre Canguro (CMC) en la sensibilidad materna en una muestra de madres adolescentes con alto riesgo psicosocial. Se compararon dos grupos de díadas: madres adolescentes con bebés prematuros en cuidado madre canguro y madres adolescentes con bebés a término en cuidado regular. Se realizaron observaciones en el medio familiar para evaluar la calidad del cuidado materno. Los análisis indican que no existen diferencias significativas entre los dos grupos de madres adolescentes respecto a la calidad de cuidado materno. Este hallazgo permite suponer un efecto protector por parte del CMC en las díadas madres adolescente-bebé prematuros, ya que esta condición del bebé es un factor de riesgo adicional a las condiciones del grupo a término en cuidado regular. Estos resultados preliminares plantean la necesidad de continuar explorando los efectos de la intervención canguro en la sensibilidad materna especialmente en poblaciones vulnerable

Between longings, longings and uncertainties: stories of older adults from the Juan XXIII neighborhood (Bogotá)

Entre añoranzas, anhelos e incertidumbres surge de una experiencia de indagación narrativa y creativa, que se pregunta por las formas en las que los seres humanos le dan sentido a su existencia y generan aprendizajes profundos en su vida cotidiana. Este libro está compuesto por cinco relatos, que son producto de una serie de conversaciones sobre las vivencias de algunos adultos mayores, que, siendo niños, poblaron parte de los cerros orientales de la ciudad de Bogotá y participaron en la creación y fundación del barrio Juan XXIII, en la localidad de Chapinero. Los relatos de estas personas, que se conectan entre sí, son narraciones espontáneas que se articulan en tres ejes: sus añoranzas por un pasado en el que ellos eran felices, a pesar de las limitaciones económicas y las adversidades; sus anhelos frente a la conciencia de sus pérdidas y vulnerabilidades actuales; y sus incertidumbres ante su futuro, el de sus hijos y sus nietos, quienes fluctúan entre la esperanza y la desesperación. Sus historias personales revelan una parte de la realidad de todo un país marcado por la violencia, la pobreza y la desatención estatal, pero también por la fuerza, la perseverancia y el valor de personas que han construido un espacio comunitario propio.Bogot

Characteristics of Caregiving Practices in Colombian Families with Children in Early Childhood in Forcibly Displaced Situation

El propósito del estudio fue caracterizar las prácticas de crianza del cuidador principal respecto a calidad del cuidado, prácticas disciplinarias, relaciones de apego tempranas niño-cuidador y desarrollo infantil en 10 diadas caso (cuidador-hijo), en situación de desplazamiento forzado por conflicto armado interno en Colombia con niños en primera infancia. El diseño fue mixto explicativo con instrumentos observacionales derivados de la Teoría del Apego y medidas de autorreporte. Se encontraron asociaciones significativas entre sensibilidad del cuidador con desarrollo infantil (r = 0.63, p < 0.05), entre apego infantil con dominios de cuidado materno (r = 0.91, p < 0.01) y prácticas disciplinarias moderadas asociadas negativamente con la seguridad del apego infantil (r = -0.88, p < 0.01). Siguiendo los principios metodológicos de la Teoría Fundamentada, se obtuvieron categorías emergentes sobre transmisión intergeneracional de patrones de crianza y prácticas de cuidado infantil. Los resultados permiten identificar algunos factores protectores (procesos reflexivos respecto al uso de patrones inadecuados de crianza) y de riesgo (mantenimiento de prácticas de castigo físico, en especial con niñas).The study’s main purpose was to characterize the quality of caregiving, disciplinary practices, child attachment security, and child development in 10 families’ study cases with their young children at internal armed conflict and forcibly displaced. The methodological design was a mixed methods explanatory design. Data collected with instruments derived from Attachment Theory, and self-report measures showed significant associations between caregiver sensitivity and child development (r = 0.63, p < 0.05), and between child attachment security and maternal caregiving domains (r = 0.91, p < 0.01). Non-harsh disciplinary practices are significant and negatively associated to child attachment security (r = -0.88, p < 0.01). Following methodological principles based on Grounded Theory emergent categories were obtained about intergenerational transmission of childrearing practices and current parental caregiving practices. Findings identified some protective factors (reflective processes regarding inadequate childrearing patterns) and risk factors (maintenance of physical punishment practices, especially with girls)

Characteristics of Caregiving Practices in Colombian Families with Children in Early Childhood in Forcibly Displaced Situation

El propósito del estudio fue caracterizar las prácticas de crianza del cuidador principal respecto a calidad del cuidado, prácticas disciplinarias, relaciones de apego tempranas niño-cuidador y desarrollo infantil en 10 diadas caso (cuidador-hijo), en situación de desplazamiento forzado por conflicto armado interno en Colombia con niños en primera infancia. El diseño fue mixto explicativo con instrumentos observacionales derivados de la Teoría del Apego y medidas de autorreporte. Se encontraron asociaciones significativas entre sensibilidad del cuidador con desarrollo infantil (r = 0.63, p < 0.05), entre apego infantil con dominios de cuidado materno (r = 0.91, p < 0.01) y prácticas disciplinarias moderadas asociadas negativamente con la seguridad del apego infantil (r = -0.88, p < 0.01). Siguiendo los principios metodológicos de la Teoría Fundamentada, se obtuvieron categorías emergentes sobre transmisión intergeneracional de patrones de crianza y prácticas de cuidado infantil. Los resultados permiten identificar algunos factores protectores (procesos reflexivos respecto al uso de patrones inadecuados de crianza) y de riesgo (mantenimiento de prácticas de castigo físico, en especial con niñas).The study’s main purpose was to characterize the quality of caregiving, disciplinary practices, child attachment security, and child development in 10 families’ study cases with their young children at internal armed conflict and forcibly displaced. The methodological design was a mixed methods explanatory design. Data collected with instruments derived from Attachment Theory, and self-report measures showed significant associations between caregiver sensitivity and child development (r = 0.63, p < 0.05), and between child attachment security and maternal caregiving domains (r = 0.91, p < 0.01). Non-harsh disciplinary practices are significant and negatively associated to child attachment security (r = -0.88, p < 0.01). Following methodological principles based on Grounded Theory emergent categories were obtained about intergenerational transmission of childrearing practices and current parental caregiving practices. Findings identified some protective factors (reflective processes regarding inadequate childrearing patterns) and risk factors (maintenance of physical punishment practices, especially with girls)