The Impact of COVID-19 on Sport in Twitter: A Quantitative and Qualitative Content Analysis

[EN] The spread of the SARS-CoV-2 virus has transformed many aspects of people's daily life, including sports. Social networks have been flooded on these issues. The present study aims to analyze the tweets produced relating to sports and COVID-19. From the end of January to the beginning of May 2020, over 4,000,000 tweets on this subject were downloaded through the Twitter search API. Once the duplicates, replicas, and retweets were removed, 119,253 original tweets were analyzed. A quantitative-qualitative content analysis was used to study the selected tweets. Posts dynamics regarding sport and exercise evolved according to the COVID-19 pandemic and subsequent lockdown, shifting from considering sport as a healthy bastion to an activity exposed to disease like any other. Most media professional sporting events received great attention on Twitter, while grassroots and women's sport were relegated to a residual role. The analysis of the 30 topics identified focused on the social, sporting, economic and health impact of the pandemic on the sport. Sporting cancellations, leisure time and socialization disruptions, club bankruptcies, sports training and athletes' uncertain career development were the main concerns. Although general health measures appeared in the tweets analyzed, those addressed to sports practice were relatively scarce. Finally, this study shows the importance of Twitter as a means of conveying social attitudes towards sports and COVID-19 and its potential to generate alternative responses in future stages of the pandemic.González, L.; Devis-Devis, J.; Pellicer-Chenoll, M.; Pans, M.; Pardo-Ibáñez, A.; García-Massó, X.; Peset Mancebo, MF.... (2021). The Impact of COVID-19 on Sport in Twitter: A Quantitative and Qualitative Content Analysis. International Journal of Environmental research and Public Health (Online). 18(9):1-20. https://doi.org/10.3390/ijerph18094554S12018

Meta-analysis of individual patient data of albumin dialysis in acute-on-chronic liver failure:focus on treatment intensity

Background: Acute-on-chronic liver failure (ACLF) is a common complication of cirrhosis characterized by single or multiple organ failures and high short-term mortality. Treatment of ACLF consists of standard medical care (SMC) and organ(s) support. Whether the efficacy of artificial liver support (ALS) depends on the severity of ACLF or on the intensity of this treatment, or both, is unclear. This study aimed to further assess these issues. Methods: We performed an individual patient data meta-analysis assessing the efficacy of Molecular Adsorbent Recirculating System (MARS) in ACLF patients enrolled in prior randomized control trials (RCTs). The meta-analysis was designed to assess the effect of patient severity (ACLF grade) and treatment intensity [low-intensity therapy (LIT), SMC alone or SMC plus ⩽ 4 MARS sessions, high-intensity therapy (HIT), SMC plus > 4 MARS sessions] on mortality. Results: Three RCTs suitable for the meta-analysis (n=285, ACLF patients=165) were identified in a systematic review. SMC plus MARS (irrespective of the number of sessions) did not improve survival compared with SMC alone, neither in the complete population nor in the ACLF patients. Survival, however, was significantly improved in the subgroup of patients receiving HIT both in the entire cohort (10-day survival: 98.6% versus 82.8%, p=0.001; 30-day survival: 73.9% versus 64.3%, p=0.032) and within the ACLF patients (10-day survival: 97.8% versus 78.6%, p=0.001; 30-day survival: 73.3% versus 58.5%, p=0.041). Remarkably, HIT increased survival independently of ACLF grade. Independent predictors of survival were age, Model for End-Stage Liver Disease (MELD), ACLF grade, number of MARS sessions received, and intensity of MARS therapy. Conclusion: HIT with albumin dialysis may improve survival in patients with ACLF. Appropriate treatment schedules should be determined in future clinical trials

Randomized-controlled trial of the DIALIVE liver dialysis device vs. standard of care in patients with acute-on-chronic liver failure

BACKGROUND AND AIMS: Acute on chronic liver failure (ACLF) is characterized by severe systemic inflammation, multi-organ failure and high mortality rates. Its treatment is an urgent unmet need. DIALIVE is a novel liver dialysis device that aims to exchange d ysfunctional albumin and remove damage- and pathogen-associated molecular patterns. This first-in-man randomized, controlled clinical trial was performed with the primary aim of assessing its safety in ACLF patients with secondary aims to evaluate its clinical effects, device performance and effect on pathophysiologically-relevant biomarkers. METHODS: 32 alcoholic cirrhosis patients with ACLF were included. Patients were treated with DIALIVE for up to 5-days and end points were assessed at Day-10. Safety was assessed in all patients (n=32). The secondary aims were assessed in a pre-specified subgroup that had at least 3-treatment sessions with DIALIVE (n=30). RESULTS: There were no significant differences in 28-day mortality or occurrence of serious adverse events between the groups. Significant reduction in the severity of endotoxemia and improvement in albumin function was observed in DIALIVE group, which translated into a significant reduction in the CLIF-C (Chronic Liver Failure consortium) organ failure (p=0.018) and CLIF-C ACLF scores (p=0.042) at Day-10. Time to resolution of ACLF was significantly faster in DIALIVE group (p=0.036). Biomarkers of systemic inflammation such as IL-8 (p=0.006), cell death [cytokeratin-18: M30 (p=0.005) and M65 (p=0.029)], endothelial function [asymmetric dimethylarginine (p=0.002)] and, ligands for toll-like receptor 4 (p=0.030) and inflammasome (p=0.002) improved significantly in DIALIVE group. CONCLUSIONS: These data indicate that DIALIVE appears to be safe and impacts positively on prognostic scores and pathophysiologically relevant biomarkers in patients with ACLF. Larger, adequately powered studies are warranted to further confirm its safety and efficacy. LAY SUMMARY: This is the first-in-man clinical trial which tested DIALIVE, a novel liver dialysis device for the treatment of liver cirrhosis and acute on chronic liver failure, a condition associated with severe inflammation, organ failures and a high risk of death. The study met the primary end point confirming DIALIVE system to be safe. Additionally, it reduced inflammation with improved clinical parameters. It did not, however, reduce mortality in this small study and requires further larger clinical trials to re-confirm its safety and evaluate efficacy. CLINICAL TRIAL NUMBER: NCT03065699

Healthcare workers hospitalized due to COVID-19 have no higher risk of death than general population. Data from the Spanish SEMI-COVID-19 Registry

Aim To determine whether healthcare workers (HCW) hospitalized in Spain due to COVID-19 have a worse prognosis than non-healthcare workers (NHCW). Methods Observational cohort study based on the SEMI-COVID-19 Registry, a nationwide registry that collects sociodemographic, clinical, laboratory, and treatment data on patients hospitalised with COVID-19 in Spain. Patients aged 20-65 years were selected. A multivariate logistic regression model was performed to identify factors associated with mortality. Results As of 22 May 2020, 4393 patients were included, of whom 419 (9.5%) were HCW. Median (interquartile range) age of HCW was 52 (15) years and 62.4% were women. Prevalence of comorbidities and severe radiological findings upon admission were less frequent in HCW. There were no difference in need of respiratory support and admission to intensive care unit, but occurrence of sepsis and in-hospital mortality was lower in HCW (1.7% vs. 3.9%; p = 0.024 and 0.7% vs. 4.8%; p<0.001 respectively). Age, male sex and comorbidity, were independently associated with higher in-hospital mortality and healthcare working with lower mortality (OR 0.211, 95%CI 0.067-0.667, p = 0.008). 30-days survival was higher in HCW (0.968 vs. 0.851 p<0.001). Conclusions Hospitalized COVID-19 HCW had fewer comorbidities and a better prognosis than NHCW. Our results suggest that professional exposure to COVID-19 in HCW does not carry more clinical severity nor mortality

Cognitive function and quality of life after hepatitis C eradication – ECOVIC study

Tesis inédita de la Universidad Complutense de Madrid, Facultad de Medicina, leída el 15/02/2021La infección crónica por el virus de la hepatitis C (VHC) altera el funcionamiento cognitivo de algunos pacientes asociándose a una disminución de la calidad de vida relacionada con la salud (CVRS) y del funcionamiento. El efecto que el VHC tiene sobre el cerebro obedece a mecanismos fisiopatológicos diferentes según la fase de la enfermedad. En la fase previa al desarrollo de cirrosis predomina un efecto directo del VHC sobre el cerebro mientras que, en la fase de cirrosis, la insuficiencia hepática causa la disfunción cerebral. Se desconoce la forma en que ambas alteraciones interaccionan entre sí en los pacientes con enfermedad hepática avanzada así como el efecto que la erradicación del VHC con los nuevos antivirales pudiera tener sobre la función cognitiva y sobre la CVRS. OBJETIVOS: 1. Describir la función cognitiva, el estado de ánimo, el funcionamiento y la CVRS de acuerdo con el grado de lesión hepática y su evolución tras la erradicación del virus. 2. Identificar los factores relacionados con la presencia de disfunción cognitiva en pacientes con infección por el VHC antes y después de la erradicación...Chronic hepatitis C virus (HCV) infection influences cognitive function in some patients which is associated with a decrease in health-related quality of life (HRQoL) and functioning. According to the stage of liver disease, two different pathophysiological mechanisms are involved in cognitive impairment (CI). Before the development of cirrhosis, a direct neuropathic effect of the HCV prevails, while in the cirrhotic stage liver failure is the main driver of cognitive dysfunction. The way that both mechanisms interplay in patients with advanced liver disease is unknown, as well as the effect that viral eradication with the new direct antiviral agents (DAA) may have on cognitive function and HRQoL. ENDPOINTS: 1. To describe cognitive function, mood, functioning and HRQoL according to the stage of liver disease at baseline and after viral eradication. 2. To identify characteristics related to the presence of CI at baseline and after HCV eradication...Fac. de MedicinaTRUEunpu

Rebleeding and mortality risk are increased by ACLF but reduced by pre-emptive TIPS

Background & Aims: The relationship between acute-on-chronic liver failure (ACLF) and acute variceal bleeding (AVB) is poorly understood. Specifically, the prevalence and prognosis of ACLF in the context of AVB is unclear, while the role of trans-jugular intrahepatic portosystemic shunt (TIPS) in the management in patients with ACLF has not been described to date. Methods: A multicenter, international, observational study was conducted in 2,138 patients from 34 centers between 2011 and 2015. ACLF was defined and graded according to the EASL-CLIF consortium definition. Placement of pre-emptive TIPS (pTIPS) was based on individual center policy. Patients were followed-up for 1 year, until death or liver transplantation. Cox regression and competing risk models (Gray's test) were used to identify independent predictors of rebleeding or mortality. Results: At admission, 380/2,138 (17.8%) patients had ACLF according to EASL-CLIF criteria (grade 1: 38.7%; grade 2: 39.2%; grade 3: 22.1%). The 42-day rebleeding (19% vs. 10%; p<0.001) and mortality (47% vs. 10%; p<0.001) rates were higher in patients with ACLF and increased with ACLF grades. Of note, the presence of ACLF was independently associated with rebleeding and mortality. pTIPS placement improved survival in patients with ACLF at 42 days and 1 year. This effect was also observed in propensity score matching analysis of 66 patients with ACLF, of whom 44 received pTIPs and 22 did not. Conclusions: This large multicenter international real-life study identified ACLF at admission as an independent predictor of rebleeding and mortality inpatients with AVB. Moreover, pTIPS was associated with improved survival in patients with ACLF and AVB. Lay summary: Acute variceal bleeding is a deadly complication of liver cirrhosis that results from severe portal hypertension. This study demonstrates that the presence of acute-on-chronic liver failure (ACLF) is the strongest predictor of mortality in patients with acute variceal bleeding. Importantly, patients with ACLF and acute variceal (re)bleeding benefit from pre-emptive (early) placement of a transjugular intrahepatic portosystemic shunt. (C) 2020 European Association for the Study of the Liver. Published by Elsevier B.V

CT-derived liver and spleen volume accurately diagnose clinically significant portal hypertension in patients with hepatocellular carcinoma

Background &amp; Aims: Clinically significant portal hypertension (CSPH) is a landmark in the natural history of cirrhosis, influencing clinical decisions in patients with hepatocellular carcinoma (HCC). Previous small series suggested that splanchnic volume measurements may predict portal hypertension. We aimed to evaluate whether volumetry obtained by standard multidetector computerised tomography (MDCT) can predict CSPH in patients with HCC. Methods: We included 175 patients with HCC, referred for hepatic venous pressure gradient (HVPG) evaluation, in whom contemporary MDCT was available. Liver volume, spleen volume (SV) and liver segmental volume ratio (LSVR: volume of the segments I-III/volume of the segments IV-VIII) were calculated semi-automatically from MDCT. Other non-invasive tests (NITs) were also employed. Results: Volume parameters could be measured in almost 100% of cases with an excellent inter-observer agreement (intraclass correlation coefficient >0.950). SV and LSVR were independently associated with CSPH (HVPG ≥10 mmHg) and did not interact with aetiology. The volume Index (VI), calculated as the product of SV and LSVR, predicted CSPH (AUC 0.83; 95% CI 0.77–0.89). Similar results were observed in an external cohort (n = 23) (AUC 0.87; 95% CI 0.69–1.00). Setting a sensitivity and specificity of 98%, VI could have avoided 35.9% of HVPG measurements. The accuracy of VI was similar to that of other NITs. VI also accurately predicted HVPG greater than 12, 14, 16 and 18 mmHg (AUC 0.81 [95% CI 0.74–0.88], 0.84 [95% CI 0.77–0.91], 0.85 [95% CI 0.77–0.92] and 0.87 [95% CI 0.79–0.94], respectively). Conclusions: Quantification of liver and spleen volumes by MDCT is a simple, accurate and reliable method of CSPH estimation in patients with compensated cirrhosis and HCC. Impact and implications: An increase in portal pressure strongly impacts outcomes after surgery in patients with early hepatocellular carcinoma (HCC). Direct measurement through hepatic vein catheterization remains the reference standard for portal pressure assessment, but its invasiveness limits its application. Therefore, we evaluated the ability of CT scan-based liver and spleen volume measurements to predict portal hypertension in patients with HCC. Our results indicate that the newly described index, based on quantification of liver and spleen volume, accurately predicts portal hypertension. These results suggest that a single imaging test may be used to diagnose and stage HCC, while providing an accurate estimation of portal hypertension, thus helping to stratify surgical risks