First wave of COVID-19 in Venezuela:Epidemiological, clinical, and paraclinical characteristics of first cases

The coronavirus disease 2019 (COVID-19) pandemic has particularly affected countries with weakened health services in Latin America, where proper patient management could be a critical step to address the epidemic. In this study, we aimed to characterize and identify which epidemiological, clinical, and paraclinical risk factors defined COVID-19 infection from the first confirmed cases through the first epidemic wave in Venezuela. A retrospective analysis of consecutive suspected cases of COVID-19 admitted to a sentinel hospital was carried out, including 576 patient cases subsequently confirmed for severe acute respiratory syndrome coronavirus 2 infection. Of these, 162 (28.1%) patients met the definition criteria for severe/critical disease, and 414 (71.2%) were classified as mild/moderate disease. The mean age was 47 (SD 16) years, the majority of which were men (59.5%), and the most frequent comorbidity was arterial hypertension (23.3%). The most common symptoms included fever (88.7%), headache (65.6%), and dry cough (63.9%). Severe/critical disease affected mostly older males with low schooling (p < 0.001). Similarly, higher levels of glycemia, urea, aminotransferases, total bilirubin, lactate dehydrogenase, and erythrocyte sedimentation rate were observed in severe/critical disease patients compared to those with mild/moderate disease. Overall mortality was 7.6% (44/576), with 41.7% (28/68) dying in hospital. We identified risk factors related to COVID-19 infection, which could help healthcare providers take appropriate measures and prevent severe clinical outcomes. Our results suggest that the mortality registered by this disease in Venezuela during the first epidemic wave was underestimated. An increase in fatalities is expected to occur in the coming months unless measures that are more effective are implemented to mitigate the epidemic while the vaccination process is ongoing

COVID-19 en Venezuela: Experiencia del Hospital Universitario de Caracas

La enfermedad por Coronavirus 2019 (COVID-19) contin&uacute;a siendo un serio problema de salud p&uacute;blica en todo el mundo, sin embargo, hasta la fecha, existe informaci&oacute;n limitada sobre el comportamiento de esta pandemia en Am&eacute;rica Latina y en particular en Venezuela. En este trabajo se describe la experiencia del Hospital Universitario de Caracas (HUC) durante la pandemia de la COVID-19.Coronavirus Disease 2019 (COVID-19) continues to be a serious public health problem around the world, however, to date, there is limited information on the behavior of this pandemic in Latin America and in particular in Venezuela. In this article, we describe the experience of the Caracas University Hospital (HUC) during the COVID-19 pandemic

Conocimientos, actitudes y prácticas hacia COVID-19 entre pacientes atendidos en la tienda de triaje del Hospital Universitario de Caracas: un estudio transversal en Venezuela: CAP hacia COVID-19 en Venezuela

Introduction: Knowledge, attitudes, and practices (KAP) studies related to coronavirus disease 2019 (COVID-19) allow the identification of erroneous concepts and inadequate practices about this disease. This baseline information is essential to design effective strategies and improve adherence to prevention measures. Objective: Identify the KAP related to COVID-19 in Venezuelan patients screened at the Caracas University Hospital triage tent. Materials and methods: A cross-sectional study was conducted on 215 patients between April 25th and May 25th, 2020 with in-person interviews using a KAP survey. Results: Most surveyed patients (53.5%) were asymptomatic. Most of them had adequate knowledge about symptoms and transmission of the disease without distinction between the symptomatic and asymptomatic groups. Most of them indicated to be practicing quarantine, frequent handwashing, and face mask use in public areas; however, daily replacement of cloth face masks was more frequent in the asymptomatic group, whereas replacement every 3 days of cloth face masks was more frequent in the symptomatic group. Finally, more than half of the participants admitted having been in crowded places, being this practice more common among the symptomatic compared to the asymptomatic patients. Conclusions: This is the first KAP study in Venezuela about COVID-19. The knowledge and practices of Venezuelans could be improved through the strengthening of education and training programs. This information obtained from the early phase of the pandemic in Venezuela could contribute to the design of COVID-19 promotion and prevention strategies.Introducción. Los estudios de conocimientos, actitudes y prácticas (CAP) relacionados con la enfermedad por coronavirus 2019 (COVID-19) permiten identificar conceptos erróneos y prácticas inadecuadas sobre esta enfermedad. Esta información de referencia es fundamental para diseñar estrategias eficaces y mejorar la adherencia a las medidas de prevención. Objetivo. Identificar los CAP relacionadas con la COVID-19 en pacientes venezolanos cribados en la carpa de triaje del Hospital Universitario de Caracas. Materiales y métodos. Se realizó un estudio transversal en 215 pacientes entre el 25 de abril y el 25 de mayo de 2020 con entrevistas personales utilizando una encuesta de CAP. Resultados. La mayoría de los pacientes encuestados (53,5%) se encontraban asintomáticos. Los pacientes encuestados tenían un conocimiento adecuado sobre los síntomas y la transmisión de la enfermedad, sin distinción entre los sintomáticos y asintomáticos. La mayoría de ellos indicó estar respetando las prácticas de cuarentena, lavado de manos frecuente y uso de tapabocas en público; sin embargo, el reemplazo diario de los tapabocas de tela fue más frecuente en el grupo de los asintomáticos, mientras que el reemplazo cada 3 días fue más común en los sintomáticos. Finalmente, más de la mitad de los participantes admitió haber estado en lugares concurridos, siendo esta práctica más frecuente en los sintomáticos que los asintomáticos. Conclusiones. Este es el primer estudio de CAP en Venezuela sobre la COVID-19. El conocimiento y las prácticas de los venezolanos podría mejorar mediante el fortalecimiento de los programas de educación y capacitación. Esta información obtenida de la fase inicial de la pandemia en Venezuela podría contribuir al diseño de estrategias de promoción y prevención de la COVID-19

Adult height and the risk of cause-specific death and vascular morbidity in 1 million people: individual participant meta-analysis.

BACKGROUND: The extent to which adult height, a biomarker of the interplay of genetic endowment and early-life experiences, is related to risk of chronic diseases in adulthood is uncertain. METHODS: We calculated hazard ratios (HRs) for height, assessed in increments of 6.5 cm, using individual-participant data on 174374 deaths or major non-fatal vascular outcomes recorded among 1085949 people in 121 prospective studies. RESULTS: For people born between 1900 and 1960, mean adult height increased 0.5-1 cm with each successive decade of birth. After adjustment for age, sex, smoking and year of birth, HRs per 6.5 cm greater height were 0.97 (95% confidence interval: 0.96-0.99) for death from any cause, 0.94 (0.93-0.96) for death from vascular causes, 1.04 (1.03-1.06) for death from cancer and 0.92 (0.90-0.94) for death from other causes. Height was negatively associated with death from coronary disease, stroke subtypes, heart failure, stomach and oral cancers, chronic obstructive pulmonary disease, mental disorders, liver disease and external causes. In contrast, height was positively associated with death from ruptured aortic aneurysm, pulmonary embolism, melanoma and cancers of the pancreas, endocrine and nervous systems, ovary, breast, prostate, colorectum, blood and lung. HRs per 6.5 cm greater height ranged from 1.26 (1.12-1.42) for risk of melanoma death to 0.84 (0.80-0.89) for risk of death from chronic obstructive pulmonary disease. HRs were not appreciably altered after further adjustment for adiposity, blood pressure, lipids, inflammation biomarkers, diabetes mellitus, alcohol consumption or socio-economic indicators. CONCLUSION: Adult height has directionally opposing relationships with risk of death from several different major causes of chronic diseases

Guidelines for the use and interpretation of assays for monitoring autophagy (4th edition)

In 2008, we published the first set of guidelines for standardizing research in autophagy. Since then, this topic has received increasing attention, and many scientists have entered the field. Our knowledge base and relevant new technologies have also been expanding. Thus, it is important to formulate on a regular basis updated guidelines for monitoring autophagy in different organisms. Despite numerous reviews, there continues to be confusion regarding acceptable methods to evaluate autophagy, especially in multicellular eukaryotes. Here, we present a set of guidelines for investigators to select and interpret methods to examine autophagy and related processes, and for reviewers to provide realistic and reasonable critiques of reports that are focused on these processes. These guidelines are not meant to be a dogmatic set of rules, because the appropriateness of any assay largely depends on the question being asked and the system being used. Moreover, no individual assay is perfect for every situation, calling for the use of multiple techniques to properly monitor autophagy in each experimental setting. Finally, several core components of the autophagy machinery have been implicated in distinct autophagic processes (canonical and noncanonical autophagy), implying that genetic approaches to block autophagy should rely on targeting two or more autophagy-related genes that ideally participate in distinct steps of the pathway. Along similar lines, because multiple proteins involved in autophagy also regulate other cellular pathways including apoptosis, not all of them can be used as a specific marker for bona fide autophagic responses. Here, we critically discuss current methods of assessing autophagy and the information they can, or cannot, provide. Our ultimate goal is to encourage intellectual and technical innovation in the field