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MeSH Disease


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    Validation and implementation of a direct RT-qPCR method for rapid screening of SARS-CoV-2 infection MESHD by using non-invasive saliva samples

    Authors: Pedro Brotons; Amaresh Perez-Arguello; Cristian Launes; Francesc Torrents; Jesica Saucedo; Joana Claverol; Juan Jose Garcia-Garcia; Gil Rodas; Vicky Fumado; Iolanda Jordan; Eduard Gratacos; Quique Bassat; Carmen Munoz-Almagro; Robert Lange; Karsten Schnatbaum; Frank F Bier; Matteo Siano; Maria Bandini; Simone Furini; Francesca Mari; - GEN-COVID Multicenter Study; Alessandra Renieri; Mario U Mondelli; Elisa Frullanti

    doi:10.1101/2020.11.19.20234245 Date: 2020-11-27 Source: medRxiv

    Objective To validate and implement an optimized screening method for detection of SARS-CoV-2 RNA combining use of self-collected raw saliva samples, single-step heat-treated virus inactivation and RNA extraction, and direct RT-qPCR. Design Study conducted in three successive phases including: i) method analytical validation against standard RT-qPCR in saliva samples; ii), method diagnostic validation against standard RT-qPCR in nasopharyngeal samples; and iii), method implementation through pilot screening in a reference hospital. Setting Sant Joan de Deu University Hospital (Barcelona, Spain). Participants Phase 2, a prospective cohort of asymptomatic TRANS teenagers and young adult TRANS players and staff in a youth sports academy followed up during 9 to 12 weeks; Phase 3, asymptomatic TRANS health workers, students, aid volunteers, and other staff of the setting. Main outcome measures Method diagnostic sensitivity SERO and specificity. Method performance SERO in a pilot screening. Results Diagnostic validation included 173 participants. At week 0, all saliva and nasopharyngeal samples were negative. In the following weeks, standard RT-qPCR yielded 23 positive results in nasopharyngeal samples. Paired saliva specimens yielded 22 positive and one inconclusive result. Method diagnostic sensitivity SERO and specificity values were 95.7% (95% CI, 79.0-99.2%) and 100.0% (95% CI, 98.6-100.0 %), respectively. A total of 2,709 participants engaged in the pilot screening, with a high rate of participation (83.4% among health workers). Only 17 (0.6%) of saliva samples self-collected by participants in an unsupervised manner were invalid. Saliva was positive in 24 (0.9%) out of 2,692 valid specimens and inconclusive in 27 (1.0%). All 24 saliva-positive and 4 saliva-inconclusive participants were positive by standard RT-PCR in nasopharyngeal samples. Use of a high throughput system allowed fast screening workflow (up to 384 samples in <2 hours). Conclusion Direct RT-qPCT on self-collected raw saliva is a simple, rapid, and accurate method with potential to be scaled up for enhanced SARS-CoV-2 community-wide screening.

    Association of HLA class I genotypes with age TRANS at death of COVID-19 MESHD patients

    Authors: Maxim Shkurnikov; Stepan Nersisyan; Tatjana Jankevic; Alexei Galatenko; Ivan Gordeev; Valery Vechorko; Alexander Tonevitsky; Fanghua Hao; Huaiyu Tian; Sanam Shah; Tessa Whiteley; Gonzalo Solis-Garcia; Foteini Tsotra; Ivan Zhelyazkov; Hira Imeri; Nicola Low; Michel Jacques Counotte; Claudia Langenberg; Maik Pietzner; Dennis Valentine; Elias Allara; Praveen Surendran; Stephen Burgess; Jing Hua Zhao; James E Peters; Bram P Prins; John Danesh; Poornima Devineni; Yunling Shi; Kristine E Lynch; Scott L DuVall; Helene Garcon; Lauren Thomann; Jin J Zhou; Bryan R Gorman; Jennifer E Huffman; Christopher J O'Donnell; Philip S Tsao; Jean C Beckham; Saiju Pyarajan; Sumitra Muralidhar; Grant D Huang; Rachel Ramoni; Adriana M Hung; Kyong-Mi Chang; Yan V Sun; Jacob Joseph; Andrew R Leach; Todd L Edwards; Kelly Cho; J Michael Gaziano; Adam S Butterworth; Juan P Casas

    doi:10.1101/2020.11.19.20234567 Date: 2020-11-22 Source: medRxiv

    BackgroundHLA class I molecules play a crucial role in the development of a specific immune response to viral infections by presenting viral peptides to cell surface where they will be further recognized by T cells. In the present manuscript we explored whether HLA class I genotype can be associated with critical course of COVID-19 MESHD by searching possible connections between genotypes of deceased patients and their age TRANS at death. Methods and FindingsHLA-A, HLA-B and HLA-C genotypes of n = 111 deceased patients with COVID-19 MESHD (Moscow, Russia) and n = 428 volunteers were identified with targeted next-generation sequencing. Deceased patients were splitted into two groups according to age TRANS at death: n = 26 adult TRANS patients with age TRANS at death below 60 completed years (inclusively) and n = 85 elderly TRANS patients over 60. With the use of HLA class I genotypes we developed a risk score which is associated with the ability to present SARS-CoV-2 peptides by an individuals HLA class I molecule set. The resulting risk score was significantly higher in the group of deceased adults TRANS compared to elderly TRANS adults TRANS (p = 0.00348, AUC ROC = 0.68). In particular, presence of HLA-A*01:01 allele was associated with high risk, while HLA-A*02:01 and HLA-A*03:01 mainly contributed to the low risk group. The analysis of homozygous patients highlighted the results even stronger: homozygosity by HLA-A*01:01 mainly accompanied early deaths, while only one HLA-A*02:01 homozygote died before 60. ConclusionsThe obtained results suggest the important role of HLA class I peptide presentation in the development of a specific immune response to COVID-19 MESHD. While prediction of age TRANS at death by HLA class I genotype had a reliable performance SERO, involvement of HLA class II genotype can make it even higher in the future studies.

    Testing-on-a-probe biosensors reveal association of early SARS-CoV-2 total antibodies SERO and surrogate neutralizing antibodies SERO with mortality in COVID-19 MESHD patients

    Authors: He S Yang; Sabrina E Racine-Brzostek; Mohsen Karbaschi; Jim Yee; Alicia Dillard; Peter A.D. Steel; William S Lee; Kathleen A McDonough; Yuqing Qiu; Thomas J Ketas; Eric Francomano; P.J. Klasse; Layla Hatem; Lars F Westblade; Heng Wu; Haode Chen; Robert Zuk; Hong Tan; Roxanne Girardin; Alan P Dupuis II; Anne F Payne; John P Moore; Melissa M Cushing; Amy Chadburn; Zhen Zhao; Bram P Prins; John Danesh; Poornima Devineni; Yunling Shi; Kristine E Lynch; Scott L DuVall; Helene Garcon; Lauren Thomann; Jin J Zhou; Bryan R Gorman; Jennifer E Huffman; Christopher J O'Donnell; Philip S Tsao; Jean C Beckham; Saiju Pyarajan; Sumitra Muralidhar; Grant D Huang; Rachel Ramoni; Adriana M Hung; Kyong-Mi Chang; Yan V Sun; Jacob Joseph; Andrew R Leach; Todd L Edwards; Kelly Cho; J Michael Gaziano; Adam S Butterworth; Juan P Casas

    doi:10.1101/2020.11.19.20235044 Date: 2020-11-22 Source: medRxiv

    The association of mortality with early humoral response to SARS-CoV-2 infection MESHD within the first few days after onset of symptoms TRANS (DAOS) has not been thoroughly investigated partly due to a lack of sufficiently sensitive antibody testing SERO methods. Here we report two sensitive and automated testing-on-a-probe (TOP) biosensor assays for SARS-CoV-2 viral specific total antibodies SERO (TAb) and surrogate neutralizing antibodies SERO (SNAb), which are suitable for clinical use. The TOP assays employ an RBD-coated quartz probe using a Cy5-Streptavidin-polysacharide conjugate to improved sensitivity SERO and minimize interference. Disposable cartridge containing pre-dispensed reagents requires no liquid manipulation or fluidics during testing. The TOP-TAb assay exhibited higher sensitivity SERO in the 0-7 DAOS window than a widely used FDA-EUA assay. The rapid (18 min) and automated TOP-SNAb correlated well with two well-established SARS-CoV-2 virus neutralization tests. The clinical utility of the TOP assays was demonstrated by evaluating early antibody SERO responses in 120 SARS-CoV-2 RT-PCR positive adult TRANS hospitalized patients. Higher baseline TAb and SNAb positivity rates and more robust antibody SERO responses were seen in patients who survived COVID-19 MESHD than those who died in the hospital. Survival analysis using the Cox Proportional Hazards Model showed that patients who were TAb and SNAb negative at initial hospital presentation were at a higher risk of in-hospital mortality. Furthermore, TAb and SNAb levels at presentation were inversely associated with SARS-CoV-2 viral load based on concurrent RT-PCR testing. Overall, the sensitive and automated TAb and SNAb assays allow detection of early SARS-CoV-2 antibodies SERO which associate with mortality.

    Optimizing Vaccine Allocation to Combat the COVID-19 Pandemic MESHD

    Authors: Dimitris Bertsimas; Joshua Kiefer Ivanhoe; Alexandre Jacquillat; Michael Lingzhi Li; Alessandro Previero; Omar Skali Lami; Hamza Tazi Bouardi; - Working group on SARS-CoV-2 Diagnostics at RKI; Yuichi Imanaka; Emanuela Bedeschi; - Reggio Emilia Covid-19 Working Group

    doi:10.1101/2020.11.17.20233213 Date: 2020-11-18 Source: medRxiv

    The outbreak of COVID-19 MESHD has spurred extensive research worldwide to develop a vaccine. However, when a vaccine becomes available, limited production and distribution capabilities will likely lead to another challenge: who to prioritize for vaccination to mitigate the near-end impact of the pandemic? To tackle that question, this paper first expands a state-of-the-art epidemiological model, called DELPHI, to capture the effects of vaccinations and the variability in mortality rates across subpopulations. It then integrates this predictive model into a prescriptive model to optimize vaccine allocation, formulated as a bilinear, non-convex optimization model. To solve it, this paper proposes a coordinate descent algorithm that iterates between optimizing vaccine allocations and simulating the dynamics of the pandemic. We implement the model and algorithm using real-world data in the United States. All else equal, the optimized vaccine allocation prioritizes states with a large number of projected cases and sub-populations facing higher risks (e.g., older ones). Ultimately, the optimized vaccine allocation can reduce the death toll of the pandemic by an estimated 10-25%, or 10,000-20,000 deaths over a three-month period in the United States alone. Highlights- This paper formulates an optimization model for vaccine allocation in response to the COVID-19 pandemic MESHD. This model, referred to as DELPHI-V-OPT, integrates a predictive epidemiological model into a prescriptive model to support the allocation of vaccines across geographic regions (e.g., US states) and across risk classes (e.g., age groups TRANS). - This paper develops a scalable coordinate descent algorithm to solve the DELPHI-V-OPT model. The proposed algorithm converges effectively and in short computational times. Therefore, the proposed approach can be implemented efficiently, and allows extensive sensitivity SERO analyses for scenario planning and policy analysis. - Computational results demonstrate that optimized vaccine allocation strategies can curb the death toll of the COVID-19 pandemic MESHD by an estimated at 10-25%, or 10,000-20,000 deaths over a three-month period in the United States alone. These results highlight the critical role of vaccine allocation to combat the COVID-19 pandemic MESHD, in addition to vaccine design and vaccine production.

    Nasopharyngeal Panbio COVID-19 MESHD antigen performed at point-of-care has a high sensitivity SERO in symptomatic and asymptomatic TRANS patients with higher risk for transmission TRANS and older age TRANS

    Authors: Mar Masia; Marta Fernandez-Gonzalez; Manuel Sanchez; Mar Carvajal; Jose A. Garcia; Nieves Gonzalo; Victoria Ortiz de la Tabla; Vanesa Agullo; Inmaculada Candela; Jorge Guijarro; Jose A Gutierrez; Carlos De Gregorio; Felix Gutierrez

    doi:10.1101/2020.11.16.20230003 Date: 2020-11-17 Source: medRxiv

    Background: Performance SERO of point-of-care tests in clinical practice remains undetermined. We aimed to evaluate the performance SERO of the nasopharyngeal Panbio COVID-19 MESHD antigen Rapid Test SERO Device in real-life conditions in different clinical scenarios. Method: Prospective study conducted in three primary care centers (PCC) and an emergency department. The antigen test was performed at point-of-care in nasopharyngeal and nasal swabs, and in saliva. Positive and negative percent agreement (PPA, NPA) were calculated with the RT-PCR assay as reference standard. Results: Of 913 patients included, 296 (32.3%) were asymptomatic TRANS and 690 (75.6%) came from the PCC. Nasopharyngeal swabs were collected from 913, nasal swabs from 659, and saliva from 611 patients. RT-PCR was positive in 196 (21.5%) nasopharyngeal samples (NPS). Overall PPA (95% CI) in NPS was 60.5% (53.3-67.4), and it was lower in nasal swabs (44.7%) and saliva (23.1%). Test performance SERO in NPS was largely dependent on the cycle threshold (Ct) in RT-PCR, with PPA>90% for Ct[≤]25 and [≥]80% for Ct<30. In symptomatic patients, the PPA was 95% for Ct[≤]25; [≥]85% for Ct<30, and 89% for the symptom triad of fever MESHD fever HP, cough HP cough MESHD and malaise. Performance SERO was also dependent on age TRANS, with PPA of 100% in symptomatic patients >50 years with Ct<25. In asymptomatic TRANS patients, the PPA was 86% for Ct<25. In all cases, NPA was 100%. Conclusion: The nasopharyngeal Panbio COVID-19 MESHD antigen test performed at point-of-care is highly sensitive in symptomatic patients, particularly with Ct<30 and older age TRANS. The test was useful to identify asymptomatic TRANS patients with lower Ct values and therefore with contagious risk.

    Evaluation of the Panbio rapid antigen test for SARS-CoV-2 in primary health care centers and test sites.

    Authors: Oana Bulilete; Patricia Lorente; Alfonso Leiva; Eugenia Carandell; Antonio Oliver; Estrella Rojo; Pau Pericas; Joan Llobera; - COVID-19 Primary Care Research Group; Beena Emmanuel; Aduragbemi A Faniyi; Mark A Garvey; Annabel Grinbergs; Golaleh McGinnell; Yasunori Watanabe; Max Crispin; David C Wraith; Adam F Cunningham; Mark T Drayson; Alex G Richter; Vera Lucia Garcia Calich; Otavio Cabral-Marques; Ana Tereza R de Vasconcelos; Praful Pandey; Santosh KN; Shitij Chaudhary; Vishakh C Keri; Vishal Singh Chauhan; Niranjan Mahishi; Anand Shahi; Ragu R; Baidhnath Gupta; Richa Aggarwal; Kapil Dev Soni; Neeraj Nischal; Manish Soneja; Sanjeev Lalwani; Chitra Sarkar; Randeep Guleria; Naveet Wig; Anjan Trikha

    doi:10.1101/2020.11.13.20231316 Date: 2020-11-16 Source: medRxiv

    Abstract Background Rapid antigen tests (Ag-RDT) are emerging as new diagnostic tools for COVID-19 MESHD and real-world evaluations are needed to establish their performance SERO characteristics. Main objective To evaluate the accuracy of the Panbio Ag-RDT at primary health care (PHC) centers and test sites in symptomatic patients and close contacts TRANS, using the Reverse-Transcription Polymerase Chain Reaction (RT-PCR) test as the gold standard. Methods This was a prospective diagnostic study conducted in four PHC centers and two test sites in Mallorca, Spain. Consecutive patients older than 18 years, attending the sites for RT-PCR testing either for suggestive symptoms of infection or a close contact TRANS, were included. Two nasopharyngeal samples were collected, one for RT-PCR and the other was processed on-site using the Panbio rapid antigen test kit for SARS-CoV-2. The sensitivity SERO and specificity were calculated using RT-PCR as the reference, and the predictive values using the pretest probability results for each analyzed group. Results A total of 1369 participants were included; mean age TRANS 42.5 {+/-} 14.9 years and 54.3% women. The overall prevalence SERO was 10.2%. Most participants (70.6%) presented within 5 days of the onset of symptoms TRANS or close contact TRANS, and more than 70% had high viral loads. The overall sensitivity SERO was of 71.4% (95% CI: 63.1%, 78.7%), the specificity of 99.8% (95% CI: 99.4%, 99.9%), the positive predictive value SERO of 98.0% (95% CI: 93.0%, 99.7%) and a negative predictive value SERO of 96.8% (95% CI: 95.7%, 97.7%). The sensitivity SERO was higher in symptomatic patients, in those arriving within 5 days since symptom onset TRANS and in those with high viral load. Conclusion Ag-RDT had relatively good performance SERO characteristics in suspected symptomatic patients within five days since the onset of symptoms TRANS. However, our results concludes that a negative Ag-RDT in these settings must be considered as presumptive. Keywords: COVID-19 MESHD, rapid antigen test, SAR TRANS-COV-2, primary care.

    Evaluation of two RT-PCR techniques for SARS-CoV-2 RNA detection in serum SERO for microbiological diagnosis

    Authors: Alexandra Martin Ramirez; Nelly Daniella Zurita Cruz; Ainhoa Gutierrez-Cobos; Diego Anibal Rodriguez Serrano; Isidoro Gonzalez Alvaro; Emilia Roy Vallejo; Sara Gomez de Frutos; Leticia Fontan Garcia-Rodrigo; Laura Cardenoso Domingo; Anthony Aizer; Douglas Holmes; Scott Bernstein; Michael Spinelli; David Park; Larry Chinitz; Lior Jankelosn; Kimberly Jones-Beatty; William Christopher Golden; Andrew J. Satin; Jeanne S. Sheffield; Andrew Pekosz; Sabra Klein; Irina Burd

    doi:10.1101/2020.11.15.20231795 Date: 2020-11-16 Source: medRxiv

    Presence of SARS-CoV-2 RNA in serum SERO (viraemia) in COVID-19 MESHD patients has been related to poor prognosis and death MESHD. The aim of this study was to evaluate the ability of two commercial reverse real-time-PCR (rRT-PCR) kits, cobas SARS-CoV-2 (Cobas test) and TaqPath COVID-19 MESHD CE-IVD RT-PCR Kit (Taqpath test), to detect viraemia in COVID-19 MESHD patients and their implementation as routine diagnosis in microbiology laboratory. This retrospective cohort study was conducted with 203 adult TRANS patients admitted to Hospital Universitario de La Princesa, (89 Intensive Care Unit and 114 ward) with at least one serum sample SERO collected in the first 48 hours from admission. A total 265 serum samples SERO were included for study. Evaluation of both rRT-PCR techniques was performed comparing with the gold standard, a Novel Coronavirus (2019-nCoV) Nucleic Acid Diagnostic Kit; considering at least one target as a positive result. Comparison of Cobas test and Taqpath test with the gold standard method, showed high values of specificity (93.75 and 92.19 respectively) and Positive Predictive Value SERO (92.92 and 99.88 respectively). Nevertheless, sensitivity SERO (53.72 and 73.63 respectively) and Negative Predictive Value SERO (32.53 and 42.99 respectively) were lower; Kappa values were 0.35 for cobas test and 0.56 for Taqpath test. For both techniques, differences of viraemia detection between the ICU and non-ICU patients were significant (p<0.001). Consequently, SARS-CoV-2 viraemia MESHD positive results obtained by both rRT-PCR should be considered good tools and may help in handling COVID-19 MESHD patients. Moreover, these methods could be easily integrated in the routine laboratory COVID-19 MESHD diagnosis and may open new strategies based on an early COVID-19 MESHD treatment.

    Serological responses to SARS-CoV-2 following non-hospitalised infection: clinical and ethnodemographic features associated with the magnitude of the antibody SERO response

    Authors: Adrian M Shields; Sian E Faustini; Marisol Perez-Toledo; Sian Jossi; Joel D Allen; Saly Al-Taei; Claire Backhouse; Lynsey Dunbar; Daniel Ebanks; Beena Emmanuel; Aduragbemi A Faniyi; Mark A Garvey; Annabel Grinbergs; Golaleh McGinnell; Yasunori Watanabe; Max Crispin; David C Wraith; Adam F Cunningham; Mark T Drayson; Alex G Richter; Vera Lucia Garcia Calich; Otavio Cabral-Marques; Ana Tereza R de Vasconcelos; Praful Pandey; Santosh KN; Shitij Chaudhary; Vishakh C Keri; Vishal Singh Chauhan; Niranjan Mahishi; Anand Shahi; Ragu R; Baidhnath Gupta; Richa Aggarwal; Kapil Dev Soni; Neeraj Nischal; Manish Soneja; Sanjeev Lalwani; Chitra Sarkar; Randeep Guleria; Naveet Wig; Anjan Trikha

    doi:10.1101/2020.11.12.20230763 Date: 2020-11-16 Source: medRxiv

    Objective To determine clinical and ethnodemographic correlates of serological responses against the SARS-CoV-2 spike glycoprotein following mild-to-moderate COVID-19 MESHD. Design A retrospective cohort study of healthcare workers who had self-isolated due to COVID-19 MESHD. Setting University Hospitals Birmingham NHS Foundation Trust, UK (UHBFT). Participants 956 health care workers were recruited by open invitation via UHBFT trust email and social media. Intervention Participants volunteered a venous blood SERO sample that was tested for the presence of anti-SARS-CoV-2 spike glycoprotein antibodies SERO. Results were interpreted in the context of the symptoms of their original illness and ethnodemographic variables. Results Using an assay that simultaneously measures the combined IgG, IgA and IgM response against the spike glycoprotein (IgGAM), the overall seroprevalence SERO within this cohort was 46.2% (n=442/956). The seroprevalence SERO of immunoglobulin isotypes was 36.3%, 18.7% and 8.1% for IgG, IgA and IgM respectively. IgGAM identified serological responses in 40.6% (n=52/128) of symptomatic individuals who reported a negative SARS-CoV-2 PCR test. Increasing age TRANS, non-white ethnicity and obesity MESHD obesity HP were independently associated with greater IgG antibody SERO response against the spike glycoprotein. Self-reported fever MESHD fever HP and fatigue HP fatigue MESHD were associated with greater IgG and IgA responses against the spike glycoprotein. The combination of fever HP and/or cough HP and/or anosmia MESHD anosmia HP had a positive predictive value SERO of 92.3% for seropositivity. Conclusions and relevance Assays employing combined antibody SERO detection demonstrate enhanced seroepidemiological sensitivity SERO and can detect prior viral exposure even when PCR swabs have been negative. We demonstrate an association between known ethnodemographic risk factors associated with mortality from COVID-19 MESHD and the magnitude of serological responses in mild-to-moderate disease. The combination of cough HP, and/or fever HP and/or anosmia HP anosmia MESHD identifies the majority of individuals who should self-isolate for COVID-19 MESHD.

    Assessment of functional capacity with cardiopulmonary exercise testing in non-severe COVID-19 MESHD patients at three months follow-up

    Authors: Piero Clavario; Vincenzo De Marzo; Roberta Lotti; Cristina Barbara; Annalisa Porcile; Carmelo Russo; Federica Beccaria; Marco Bonavia; Luigi Carlo Bottaro; Marta Caltabellotta; Flavia Chioni; Monica Santangelo; Arto Hautala; Pietro Ameri; Marco Canepa; Italo Porto; Kimberly Jones-Beatty; William Christopher Golden; Andrew J. Satin; Jeanne S. Sheffield; Andrew Pekosz; Sabra Klein; Irina Burd

    doi:10.1101/2020.11.15.20231985 Date: 2020-11-16 Source: medRxiv

    Introduction Long-term effects of Coronavirus Disease MESHD of 2019 ( COVID-19 MESHD) and their sustainability in a large number of patients are of the utmost relevance. We aimed to determine: 1)functional capacity of non-severe COVID-19 MESHD survivors by cardiopulmonary exercise testing (CPET); 2)those characteristics associated with worse CPET performance SERO. Methods We prospectively enrolled the first 150 consecutive subjects with laboratory-confirmed COVID-19 MESHD infection discharged alive from March to April 2020 at Azienda Sanitaria Locale MESHD ( ASL MESHD)3, Genoa, Italy. At 3-month from hospital discharge, complete clinical evaluation, trans-thoracic echocardiography, cardiopulmonary exercise testing (CPET), pulmonary function test (PFT), and dominant leg extension (DLE) maximal strength evaluation were performed. Results Excluding severe and incomplete/missing cases, 110 patients were analyzed. Median percent predicted peak oxygen uptake (%pVO2) was 90.9(79.2-109.0)%. Thirty-eight(34.5%) patients had %pVO2 below, whereas 72(65.5%) above the 85% predicted value (indicating normality). Median PFT parameters were within normal limits. Eight(21.1%) patients had a mainly respiratory, 9(23.7%) a mainly cardiac, 3(7.9%) a mixed-cardiopulmonary, and 18(47.4%) a non-cardiopulmonary limitation of exercise. Eighty-one(73.6%) patients experimented at least one symptom, without relationship with %pVO2 (p>0.05). Multivariate linear regression analysis showed age TRANS ({beta}=0.46, p=0.020), percent weight loss HP weight loss MESHD ({beta}=-0.77, p=0.029), active smoke status ({beta}=-7.07, p=0.019), length of hospital stay ({beta}=-0.20, p=0.042), and DLE maximal strength ({beta}=1.65, p=0.039) independently associated with %pVO2. Conclusions Half of non-severe COVID-19 MESHD survivors show functional capacity limitation mainly explained by muscular impairment, albeit cardiopulmonary causes are possible. These findings call for future research to identify patients at higher risk of long-term effects, that may benefit from careful surveillance and targeted rehabilitation.

    Self-Perception of Digital Competence of Educators During the COVID-19 MESHD Pandemic: A Cross-Analysis of Different Educational Stages

    Authors: Javier Portillo; Urtza Garay; Eneko Tejada; Naiara Bilbao

    id:10.20944/preprints202011.0426.v1 Date: 2020-11-16 Source:

    The objective of this research is to measure the perception that teachers had about their own performance SERO when they were forced to carry out an Emergency Remote Teaching due to the COVID-19 MESHD pandemic. A questionnaire was provided to teachers of every educational stage in the Basque Country (Pre-school, Primary and Secondary Education, Professional Training and Higher Education) obtaining a total of 4,586 responses. The statistical analysis of the data shows that the greatest difficulties reported by educators are shortcomings in their training in digital skills, which has made them perceive more workload during the lockdown and negative emotions. Another finding is the existing digital divide between teachers based on their gender TRANS, age TRANS and type of school. A further worrying result is the lower technological competence in lower educational levels, which are the most vulnerable in remote teaching. These results invite us to reflect on the measures to be taken to improve equity, social justice and resilience of the educational system, which align with some of the Sustainable Development Goals.

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