Associações entre temperamento regulação do cortisol em pré-escolares de lares pobres

El presente trabajo propone analizar las asociaciones entre el temperamento y la regulación del cortisol en una muestra de 46 niños y niñas de 5 años de edad, de hogares pobres; así como el rol modulador del sexo y las condiciones socio-ambientales de los hogares, en tales asociaciones. Los resultados sugieren una mayor proporción de descenso del cortisol matutino durante la noche para las niñas con niveles más bajos de afectividad negativa, los niños con niveles más altos de esfuerzo de control, así como para las niñas y los niños de hogares con mejores condiciones socio-ambientales y con niveles más altos de esfuerzo de control. Asimismo, se identificaron asociaciones específicas entre los valores de regulación del cortisol y un conjunto de 12 ítems del cuestionario de temperamento, en su mayoría correspondientes a la dimensión afectividad negativa. Estos resultados aportan evidencia al estudio de las diferencias individuales del desarrollo autorregulatorio en la niñez, considerando diferentes niveles de organización.The present work proposes to analyze the associations between temperament and cortisol regulation in a sample of 46 boys and girls of 5years-old, from poor homes; as well as the modulating role of sex and the socio-environmental conditions of households in such associations. The results suggest a higher proportion of morning cortisol decline during the night for girls with lower levels of negative affectivity, boys with higher levels of effortful control, as well as for children from homes with better socio-environmental conditions, and with higher levels of effortful control. Likewise, specific associations were identified between cortisol regulation and a set of 12 items of the temperament questionnaire, most of them corresponding to the negative affectivity dimension. These results provide evidence for the study of self-regulatory development in childhood, considering different levels of organization.Este artigo propõe analisar as associações entre temperamento e regulação do cortisol em uma amostra de 46 meninos e meninas de 5 anos de idade de famílias pobres; bem como o papel modulador do sexo e as condições socioambientais das famílias, nessas associações. Os resultados sugerem uma proporção maior de declínio matinal do cortisol durante a noite para meninas com níveis mais baixos de afetividade negativa, meninos com níveis mais altos de esforço de controle, assim como meninas e meninos em domicílios com melhores condições socioeconómicas - ambientais e com níveis mais altos de esforço de controle. Da mesma forma, foram identificadas associações específicas entre os valores de regulação do cortisol e um conjunto de 12 itens do questionário de temperamento, correspondendo principalmente à dimensão afetiva negativa. Esses resultados evidenciam o estudo das diferenças individuais do desenvolvimento autorregulador na infância, considerando diferentes níveis de organização.Fil: Segretin, María Soledad. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. CEMIC-CONICET. Centro de Educaciones Médicas e Investigaciones Clínicas "Norberto Quirno". CEMIC-CONICET; ArgentinaFil: Prats, Lucía María. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. CEMIC-CONICET. Centro de Educaciones Médicas e Investigaciones Clínicas "Norberto Quirno". CEMIC-CONICET; ArgentinaFil: Lipina, Sebastián Javier. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. CEMIC-CONICET. Centro de Educaciones Médicas e Investigaciones Clínicas "Norberto Quirno". CEMIC-CONICET; Argentin

El rol mediador de la pobreza en la asociación entre factores ambientales y el desempeño cognitivo de preescolares

La asociación entre los factores ambientales y el desempeño cognitivo durante la infancia podría estar mediada por la pertenencia a hogares pobres (i.e., hogares con necesidades básicas insatisfechas o satisfechas). Este estudio exploró tal mediación en preescolares de diferentes contextos socioeconómicos. Para tal fin, se administraron tareas que demandaron atención ejecutiva, memoria de trabajo, control inhibitorio, planificación y razonamiento fluido a 250 niños/as de 4 y 5 años. Los resultados sugirieron que la pobreza medió los efectos de la composición familiar, la salud infantil, los factores de riesgo para la salud, cantidad de niños/as y adultos en el hogar, la edad materna y las actividades de alfabetización sobre la atención ejecutiva, el razonamiento fluido y el control inhibitorio. Estos resultados contribuyen a la comprensión de la relación entre los factores ambientales y el desarrollo cognitivo a través de la identificación de la pobreza como variable mediadora.The association between environmental factors and cognitive performance during childhood could be mediated by poverty (i.e., households with Unsatisfied or Satisfied Basic Needs). This study explored such mediating roles in preschoolers from different socioeconomic backgrounds. Tasks to assess executive attention, working memory, inhibitory control, planning, and fluid reasoning were administered to 250 children aged 4 and 5 years. The results suggested that poverty mediated the effects of family composition, child health, health risk factors, children and adults at home, maternal age, and literacy activities on the performance of executive attention, fluid reasoning, and inhibitory control. These results contribute to our understanding of the relationship between environmental factors and cognitive development through the identification of the mediating role of poverty.Fil: Fracchia, Carolina Soledad. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. CEMIC-CONICET. Centro de Educaciones Médicas e Investigaciones Clínicas "Norberto Quirno". CEMIC-CONICET; ArgentinaFil: Segretin, María Soledad. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. CEMIC-CONICET. Centro de Educaciones Médicas e Investigaciones Clínicas "Norberto Quirno". CEMIC-CONICET; ArgentinaFil: Hermida, Maria Julia. Universidad Nacional de Hurlingham; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Prats, Lucía María. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. CEMIC-CONICET. Centro de Educaciones Médicas e Investigaciones Clínicas "Norberto Quirno". CEMIC-CONICET; ArgentinaFil: Lipina, Sebastián Javier. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. CEMIC-CONICET. Centro de Educaciones Médicas e Investigaciones Clínicas "Norberto Quirno". CEMIC-CONICET; Argentin

Disposition of d-penicillamine, a promising drug for preventing alcohol-relapse. Influence of dose, chronic alcohol consumption and age: studies in rats

Pharmacokinetic studies concerning D-penicillamine (an acetaldehyde sequestering agent) are scarce and have not evaluated the influence of chronic ethanol consumption and age on its disposition. Since recent preclinical studies propose D-penicillamine as a promising treatment for alcohol relapse, the main aim of the present work was to evaluate the influence of these two factors on D-penicillamine disposition in order to guide future clinical studies on the anti-relapse efficacy of this drug in alcoholism. Additionally, the effect of the administered dose was also evaluated. To this end, three studies were carried out. Study 1 assessed the influence of dose on D-penicillamine disposition, whereas studies 2 and 3 evaluated, respectively, the influence of chronic alcohol consumption and age. Rapid intravenous administrations of 2, 10 and 30 mg/kg of D-penicillamine were performed using young or adult ethanol-naïve rats or adult ethanol-experienced (subjected to a long-term ethanol self-administration protocol) rats. Pharmacokinetic parameters were derived from the biexponential model. Statistical analysis of CL, normalized AUC0 ∞, V1 and k10 revealed that disposition, in the range plasma concentrations assayed, is non-linear both in young ethanol-naïve and in adult ethanol-experienced rats. Notably, no significant changes in t1/2 were detected. Chronic ethanol consumption significantly reduced CL values by 35% without affecting t1/2. D-Penicillamine disposition was equivalent in young and adult animals. In conclusion, although DP pharmacokinetics is non-linear, the lack of significant alterations of the t1/2 would potentially simplify the clinical use of this drug. Chronic consumption of ethanol also alters D-penicillamine disposition but, again, does not modify t1/2. Copyright © 2014 John Wiley & Sons, Ltd.Peer ReviewMedicin

Individuality and self-regulation in preschoolers

"Different ways of solving planning and spatial working memory tasks generate different taskperformance profiles. Tests were administered to 346 (planning) and 427 (spatial working memory) Argentinean children from different socioeconomic (SES) backgrounds. A cross-sectional design was performed to explore eventual variable profiles of performance that were associated with levels of success or failure on tasks that tapped working memory and planning demands and to evaluate their association with SES backgrounds. The results showed that (1) different task-performance profiles were identified: decreased, changeless, oscillated, or increased; (2) the total score for the tasks was significantly different among these profiles; and (3) there were significant differences in the total score among SES groups, which depended on type of profile. These findings suggested the importance of studying individual differences in the performance of tasks that demand self-regulatory processes of children with SES disadvantages. This is important for the understanding of how children solve problems, and how that behavior varies according to SES." (author's abstract)"Aufgaben zum Planen und zum Arbeitsgedächtnis können verschiedenartig gelöst werden. Argentinische Kinder mit unterschiedlichem sozioökonomischen Status (SES) haben Planungsaufgaben (n=346) und Aufgaben zum visuellen Arbeitsgedächtnis (n=427) gelöst. In einem Querschnittsdesign wurden Lösungsprofile identifiziert und in Verbindung mit dem SES gebracht. Die Ergebnisse zeigten: (1) es gibt unterschiedliche Lösungsprofile: abnehmend, gleichbleibend, oszillierend und zunehmend; (2) die Gesamtpunktzahl für die Aufgaben unterschied sich signifikant zwischen den Lösungsprofilen; (3) die Leistung unterschied sich zwischen den SES-Gruppen in Abhängigkeit der Lösungsprofile. Diese Ergebnisse unterstreichen die Wichtigkeit der Betrachtung individueller Unterschiede in der Bearbeitung von Aufgaben, die Selbstregulation erfassen. Das ist bedeutsam, um zu verstehen, wie Kinder diese Aufgaben lösen und wie sich ihr Verhalten in Abhängigkeit des SES unterscheidet." (Autorenreferat

Regional differences in mu-opioid receptor-dependent modulation of basal dopamine transmission in rat striatum

The nigrostriatal dopamine system is implicated in the regulation of reward and motor activity. Dopamine (DA) release in dorsal striatum (DS) is controlled by the firing rate of DA neurons in substantia nigra pars compacta. However, influences at terminal level, such as those involving activation of mu opioid receptors (MORs), can play a key role in determining DA levels in striatum. Nonetheless, published data also suggest that the effect of opioid drugs on DA levels may differ depending on the DS subregion analysed. In this study, in vivo microdialysis in rats was used to explore this regional dependence. Changes in basal DA levels induced by local retrodialysis application of DAMGO (selective MORs agonist) in three different subregions of DS along the rostro-caudal axis were studied. Our results indicate that whereas administration of 10μM DAMGO into the rostral and caudal DS significantly reduced DA levels, in medial DS an increase in DA levels was observed. These data reveal a regional-dependent MOR modulation of DA release in DS, similar to that described in the ventral striatum. Our findings may lead to a better understanding of the nigrostriatal DA system regulation

Empathy for others' suffering and its mediators in mental health professionals

Empathy is a complex cognitive and affective process that allows humans to experience concern for others, comprehend their emotions, and eventually help them. In addition to studies with healthy subjects and various neuropsychiatric populations, a few reports have examined this domain focusing on mental health workers, whose daily work requires the development of a saliently empathic character. Building on this research line, the present population-based study aimed to (a) assess different dimensions of empathy for pain in mental health workers relative to general-physicians and non-medical workers; and (b) evaluate their relationship with relevant factors, such as moral profile, age, gender, years of experience, and workplace type. Relative to both control groups, mental health workers exhibited higher empathic concern and discomfort for others' suffering, and they favored harsher punishment to harmful actions. Furthermore, this was the only group in which empathy variability was explained by moral judgments, years of experience, and workplace type. Taken together, these results indicate that empathy is continuously at stake in mental health care scenarios, as it can be affected by contextual factors and social contingencies. More generally, they highlight the importance of studying this domain in populations characterized by extreme empathic demands.Fil: Santamaria Garcia, Hernando. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Neurociencia Cognitiva. Fundación Favaloro. Instituto de Neurociencia Cognitiva; ArgentinaFil: Báez Buitrago, Sandra Jimena. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Neurociencia Cognitiva. Fundación Favaloro. Instituto de Neurociencia Cognitiva; ArgentinaFil: García, Adolfo Martín. Instituto de Neurología Cognitiva. Laboratorio de Psicología Experimental y Neurociencia; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Neurociencia Cognitiva. Fundación Favaloro. Instituto de Neurociencia Cognitiva; Argentina. Universidad Nacional de Cuyo. Facultad de Educación Elemental y Especial; ArgentinaFil: Flichtentrei, Daniel. Intramed; ArgentinaFil: Prats, Lucía María. Intramed; Argentina. Centro de Educaciones Médicas e Investigación Clínica "Norberto Quirno"; ArgentinaFil: Mastandueno, Ricardo. Intramed; ArgentinaFil: Sigman, Mariano. Universidad Torcuato di Tella; ArgentinaFil: Matallana, Diana. Pontificia Universidad Javeriana; ColombiaFil: Cetkovich Bakmas, Marcelo Gustavo. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Neurociencia Cognitiva. Fundación Favaloro. Instituto de Neurociencia Cognitiva; ArgentinaFil: Ibanez Barassi, Agustin Mariano. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Neurociencia Cognitiva. Fundación Favaloro. Instituto de Neurociencia Cognitiva; Argentin

Disposition of d-penicillamine, a promising drug for preventing alcohol-relapse. Influence of dose, chronic alcohol consumption and age: studies in rats

Pharmacokinetic studies concerning d-penicillamine (an acetaldehyde sequestering agent) are scarce and have not evaluated the influence of chronic ethanol consumption and age on its disposition. Since recent preclinical studies propose d-penicillamine as a promising treatment for alcohol relapse, the main aim of the present work was to evaluate the influence of these two factors on d-penicillamine disposition in order to guide future clinical studies on the anti-relapse efficacy of this drug in alcoholism. Additionally, the effect of the administered dose was also evaluated. To this end, three studies were carried out. Study 1 assessed the influence of dose on d-penicillamine disposition, whereas studies 2 and 3 evaluated, respectively, the influence of chronic alcohol consumption and age. Rapid intravenous administrations of 2, 10 and 30 mg/kg of d-penicillamine were performed using young or adult ethanol-naïve rats or adult ethanol-experienced (subjected to a long-term ethanol self-administration protocol) rats. Pharmacokinetic parameters were derived from the biexponential model. Statistical analysis of CL, normalized AUC0∞, V1 and k10 revealed that disposition, in the range plasma concentrations assayed, is non-linear both in young ethanol-naïve and in adult ethanol-experienced rats. Notably, no significant changes in t1/2 were detected. Chronic ethanol consumption significantly reduced CL values by 35% without affecting t1/2. d-Penicillamine disposition was equivalent in young and adult animals. In conclusion, although DP pharmacokinetics is non-linear, the lack of significant alterations of the t1/2 would potentially simplify the clinical use of this drug. Chronic consumption of ethanol also alters d-penicillamine disposition but, again, does not modify t1/2

Predictores Socioambientales e Individuales del Desempeño en una Tarea Atencional con Demandas de Alerta, Orientación y Control.

El presente estudio explora el valor predictivo del nivel socioeconómico, la salud mental materna y el temperamento infantil sobre el desempeño en la prueba  de  redes  atencionales  (ANT),  que  evalúa  procesos  atencionales  de alerta, orientación y control, administrada a 203 niños de 4 y 5 años (M = 4.78;  DE  =  .59),  provenientes  de  hogares  con  y  sin  necesidades  básicas insatisfechas (NBI y NBS, respectivamente). Los resultados de los análisis de  regresión  lineal  indicaron  que  las  variables  género,  edad,  esfuerzo voluntario  de  control  y  en  forma  marginal  nivel  de  ocupación  parental, fueron predictores del aumento de los tiempos de reacción en las tareas con demandas de control. No se identificaron predictores en el caso de las redes atencionales  de  alerta  y  orientación.  Al  reemplazar  en  el  modelo  las variables sociodemográficas de educación y ocupación parental, vivienda y hacinamiento por el predictor grupo económico (NBI/NBS), no se verificó ningún  tipo  de  predicción.  Estos  resultados  sugieren  una  modulación diferencial  de  factores  individuales  y  ambientales  sobre  distintos  sistemas de procesamiento atencional.Palabras claves:  Desarrollo  Cognitivo;  Redes  Atencionales;  Esfuerzo  Voluntario  De Control; Salud Mental Materna; Predictores Sociodemográficos.   Sociodemographic  and  Individual  Predictors  of  Performance  in  an Attentional  Task  with  Alert,  Orienting  and  Control  Demands  in Preschoolers:  This  study  explores  the  predictive  value  of  socioeconomic status,  maternal  mental  health  and  child  temperament  on  the  performance in the attentional network test (ANT), which assesses attentional processes of alert, orienting and control, administered to 203 4-to-5 years-old children (M  =  4.78;  SD  =  .59)  from  Unsatisfied  and  Satisfied  Basic  Needs  homes (UBN  and  SBN,  respectively).  Results  from  the  linear  regression  analysis indicated  that  gender,  age,  effortful  control,  and  marginally  parental occupation,  predicted  increments  in  reaction  times  of  trials  corresponding only  to  the  control  network.  Predictors  were  not  verified  when sociodemographic  variables  (parental  education  and  occupation,  dwelling and  overcrowding)  were  replaced  in  the  model  by  the  predictor socioeconomic  group  (UBN,  SBN).  These  results  suggest  a  differential modulation of individual and environmental factors on different attentional processing networks.Cognitive Development; Attentional Networks; Effortful Control; Maternal Mental Health; Sociodemographic Predictors.     

Associação entre fatores individuais e contextuais e o desempenho cognitivo em pré-escolares com necessidades básicas insatisfeitas

En el marco de un proyecto de intervención, orientado a optimizar el desempeño cognitivo a través de actividades de juego para madres y sus hijos, este estudio presenta los resultados de un análisis de asociación entre factores (a) individuales (i.e. cortisol; actividad electroencefalográfica; lenguaje; y salud), y (b) contextuales (i.e. características del hogar; salud materna; y lenguaje materno), con la eficiencia en la solución de tareas con demandas cognitivas, en una muestra de 46 niños de 5 años de edad, sin historia del trastorno del desarrollo, y pertenecientes a hogares con NBI. Luego de aplicar análisis no paramétricos de tendencias entre grupos, los resultados indicaron a los siguientes como los factores de mayor asociación con el desempeño cognitivo: (a) conectividad y potencia neurales; y (b) lenguaje materno. El abordaje implementado contribuye con una mejora en la comprensión de las asociaciones entre factores individuales y contextuales del desempeño cognitivo, al considerar diferentes niveles de organización involucrados en su desarrollo.In the context of an experimental intervention aimed at optimizing cognitive development through play activities for mothers and their children, this study presents the results of an association analysis between (a) individual (i.e. cortisol, electroencephalographic activity, language, and health conditions), and (b) contextual factors (i.e. home characteristics, maternal health, and mother language) with the efficiency in task solution with cognitive demands, in a sample of 46 5-years-old children, with no history of developmental disorder, and from UBN homes. After applying non-parametric trend analyses between groups, the results indicated the following as the factors of greatest association with cognitive performance: (a) neural connectivity and power; and (b) mother language. The implemented approach contributes to the understanding of the associations between individual and contextual factors of cognitive performance, considering different levels of organization involved in its development.No contexto de uma intervenção experimental objetivando otimizar o desenvolvimento cognitivo através de atividades lúdicas para mães e seus filhos, este estudo apresenta os resultados de uma análise de associação entre (a) atividade individual (cortisol, atividade eletroencefalográfica, linguagem e condições de saúde) e (b) fatores contextuais (características domiciliares, saúde materna e língua materna), com a eficiência em solução de tarefas com demandas cognitivas, em uma amostra de 46 crianças de 5 anos de idade, sem história de transtorno de desenvolvimento e de domicílios com necessidades básicas insatisfeitas. Após a aplicação de análises de tendências não-paramétricas entre os grupos, os resultados indicaram os seguintes fatores de maior associação com o desempenho cognitivo: (a) conectividade neural e poder; E (b) a língua materna. A abordagem implementada contribui para a compreensão das associações entre fatores individuais e contextuais de desempenho cognitivo, considerando diferentes níveis de organização envolvidos em seu desenvolvimento.Fil: Prats, Lucía María. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. CEMIC-CONICET. Centro de Educaciones Médicas e Investigaciones Clínicas ; ArgentinaFil: Segretin, María Soledad. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. CEMIC-CONICET. Centro de Educaciones Médicas e Investigaciones Clínicas ; ArgentinaFil: Fracchia, Carolina Soledad. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. CEMIC-CONICET. Centro de Educaciones Médicas e Investigaciones Clínicas ; ArgentinaFil: Kamienkowski, Juan Esteban. Universidad de Buenos Aires. Facultad de Ciencias Exactas y Naturales. Departamento de Computación. Laboratorio de Inteligencia Artificial Aplicada; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Pietto, Marcos Luis. Universidad de Buenos Aires. Facultad de Ciencias Exactas y Naturales. Departamento de Computación. Laboratorio de Inteligencia Artificial Aplicada; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. CEMIC-CONICET. Centro de Educaciones Médicas e Investigaciones Clínicas ; ArgentinaFil: Hermida, Maria Julia. Universidad Torcuato di Tella; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. CEMIC-CONICET. Centro de Educaciones Médicas e Investigaciones Clínicas ; ArgentinaFil: Giovannetti, Federico. Centro de Educación Médica e Investigaciones Clínicas “Norberto Quirno”; ArgentinaFil: Mancini, Natalia. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. CEMIC-CONICET. Centro de Educaciones Médicas e Investigaciones Clínicas ; ArgentinaFil: Gravano, Agustin. Universidad de Buenos Aires. Facultad de Ciencias Exactas y Naturales. Departamento de Computación. Laboratorio de Inteligencia Artificial Aplicada; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Sheese, Brad. Illinois Wesleyan University; Estados UnidosFil: Lipina, Sebastián Javier. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. CEMIC-CONICET. Centro de Educaciones Médicas e Investigaciones Clínicas ; Argentin

Neurocognitive profile of the post-COVID condition in adults in Catalonia. A mixed method prospective cohort and nested case-control study: Study Protocol

The diagnosis of the post-COVID condition is usually achieved by excluding other diseases; however, cognitive changes are often found in the post-COVID disorder. Therefore, monitoring and treating the recovery from the post-COVID condition is necessary to establish biomarkers to guide the diagnosis of symptoms, including cognitive impairment. Our study employs a prospected cohort and nested case-control design with mixed methods, including statistical analyses, interviews, and focus groups. Our main aim is to identify biomarkers (functional and structural neural changes, inflammatory and immune status, vascular and vestibular signs and symptoms) easily applied in primary care to detect cognitive changes in post-COVID cases. The results will open up a new line of research to inform diagnostic and therapeutic decisions with special considerations for cognitive impairment in the post-COVID condition