SARS-CoV-2 viral load in nasopharyngeal swabs is not an independent predictor of unfavorable outcome

The aim was to assess the ability of nasopharyngeal SARS-CoV-2 viral load at first patient’s hospital evaluation to predict unfavorable outcomes. We conducted a prospective cohort study including 321 adult patients with confirmed COVID-19 through RT-PCR in nasopharyngeal swabs. Quantitative Synthetic SARS-CoV-2 RNA cycle threshold values were used to calculate the viral load in log10 copies/mL. Disease severity at the end of follow up was categorized into mild, moderate, and severe. Primary endpoint was a composite of intensive care unit (ICU) admission and/or death (n = 85, 26.4%). Univariable and multivariable logistic regression analyses were performed. Nasopharyngeal SARS-CoV-2 viral load over the second quartile (≥ 7.35 log10 copies/mL, p = 0.003) and second tertile (≥ 8.27 log10 copies/mL, p = 0.01) were associated to unfavorable outcome in the unadjusted logistic regression analysis. However, in the final multivariable analysis, viral load was not independently associated with an unfavorable outcome. Five predictors were independently associated with increased odds of ICU admission and/or death: age ≥ 70 years, SpO2, neutrophils > 7.5 × 103/µL, lactate dehydrogenase ≥ 300 U/L, and C-reactive protein ≥ 100 mg/L. In summary, nasopharyngeal SARS-CoV-2 viral load on admission is generally high in patients with COVID-19, regardless of illness severity, but it cannot be used as an independent predictor of unfavorable clinical outcome

Dendritic cell deficiencies persist seven months after SARS-CoV-2 infection

Severe Acute Respiratory Syndrome Coronavirus (SARS-CoV)-2 infection induces an exacerbated inflammation driven by innate immunity components. Dendritic cells (DCs) play a key role in the defense against viral infections, for instance plasmacytoid DCs (pDCs), have the capacity to produce vast amounts of interferon-alpha (IFN-α). In COVID-19 there is a deficit in DC numbers and IFN-α production, which has been associated with disease severity. In this work, we described that in addition to the DC deficiency, several DC activation and homing markers were altered in acute COVID-19 patients, which were associated with multiple inflammatory markers. Remarkably, previously hospitalized and nonhospitalized patients remained with decreased numbers of CD1c+ myeloid DCs and pDCs seven months after SARS-CoV-2 infection. Moreover, the expression of DC markers such as CD86 and CD4 were only restored in previously nonhospitalized patients, while no restoration of integrin β7 and indoleamine 2,3-dyoxigenase (IDO) levels were observed. These findings contribute to a better understanding of the immunological sequelae of COVID-19

Nurses' perceptions of aids and obstacles to the provision of optimal end of life care in ICU

Contains fulltext : 172380.pdf (publisher's version ) (Open Access

Ojo y Camino. Encuentros, Azar y tiempo

En materia de arte, desde finales de los 80 vengo indagando en la producción de obras que sean “lo más autónomas posible” de mis propias decisiones y, en paralelo, acometo otras tantas a las que encuadré bajo la denominación de “proyectos de larga duración en el tiempo”,que están conectadas al curso natural de la vida en general o a la mía en particular. Estas dos decisiones, se podría decir que han marcado todo mi quehacer creativo hasta el momento.En el recorrido de Ojo y Camino. Encuentros, Azar y Tiempo, la primera muestra de una trilogía, se introduce una triple reivindicación: la primera va dirigida hacia la relectura del material y del objeto encontrados a través de la huella y el rastro anónimo depositado en ellos; la segundase centra en la búsqueda de mi identidad y mis raíces vinculadas necesariamente al lugar de mi nacimiento; y la tercera pretensión la establezco con la vuelta a la pintura a finales de 2003, con ella propugno el metalenguaje de la pintura, cuando esta, alejándose de la necesidad de convertirse en representación, se vuelve objeto

Comparative-Causal Study of the Immigration’s Term in Students of the University of Granada, Spain

O presente estudo, de corte comparativo-causal, pretende verificar se diferentes variáveis inerentes aos estudantes da Universidade de Granada (como o gênero, a titulação onde cursam seus estudos, dentre outras) afetam a forma como avaliam o termo “imigração”. Foi utilizado um inventário que avaliou a percepção sobre o agrado versus desagrado do termo referido de uma amostra de (N = 423) alunos desta universidade selecionada através de uma amostragem probabilística por conglomerados. Os resultados obtidos destacam que, de fato, algumas das variáveis referidas foram relevantes na hora de avaliar positiva ou negativamente o termo imigração, sobretudo, no que diz respeito às variáveis titulação, ideologia e situação econômica dos estudantes da nossa pesquisa.El presente estudio, de corte comparativo-causal, pretende determinar si diferentes variables consustanciales al alumnado de la Universidad de Granada (como el género, titulación donde desarrolla sus estudios, etc.) inciden en la forma en cómo valoran el término de “inmigración”. Para ello utilizamos un inventario que ha evaluado la percepción de agrado vs desagrado de dicho término de una muestra de estudiantes (N = 423) de la dicha universidad seleccionados mediante un muestreo probabilístico por conglomerados. Los resultados obtenidos apuntan a que, efectivamente, algunas de las variables contempladas han resultado relevantes a la hora de valorar con mayor o menor agrado el concepto anteriormente mencionado, sobre todo, por lo que respecta a las variables titulación, ideología y situación económica del alumnado objeto de la investigación.This study, of comparative-causal type, cutting wants to determine if different variables inherent to the students of the University of Granada (as the genre, degree where they study, etc.) influence in the way they assess the term of “inmigration”. We use a survey that evaluated the perception of agree vs disagree on the term “inmigrantion” of a sample (N = 423) students of this university selected by cluster random sampling. The obtained results show that, really, some of the referred variables have shown to be relevant when assessing with varying agreement to the concept previously mentioned, over all, regarding the different degrees, ideology and the students economic situation, the object of the research

Recomendaciones para el manejo de los pacientes críticos con COVID-19 en las Unidades de Cuidados Intensivos.

The COVID-19 pandemic has led to the admission of a high number of patients to the ICU, generally due to severe respiratory failure. Since the appearance of the first cases of SARS-CoV-2 infection, at the end of 2019, in China, a huge number of treatment recommendations for this entity have been published, not always supported by sufficient scientific evidence or with methodological rigor necessary. Thanks to the efforts of different groups of researchers, we currently have the results of clinical trials, and other types of studies, of higher quality. We consider it necessary to create a document that includes recommendations that collect this evidence regarding the diagnosis and treatment of COVID-19, but also aspects that other guidelines have not considered and that we consider essential in the management of critical patients with COVID-19. For this, a drafting committee has been created, made up of members of the SEMICYUC Working Groups more directly related to different specific aspects of the management of these patients