Background:Psychopathological manifestations are key features of long COVID, contributing to a considerable global mental health burden. Neuropsychiatric sequelae such as anxiety, depression, cognitive dysfunction, and perceived stress may persist for months or years after infection. Latin American populations remain underrepresented, despite a high prevalence of long COVID and unique socio-demographic characteristics. Understanding these impacts is essential for targeted screening and interventions. Methods:We conducted a prospective study of patients hospitalized for severe COVID-19. Psychiatric evaluation used the General Anxiety Disorder-7, Patient Health Questionnaire-9, Perceived Stress Scale-14, and Addenbrooke's Cognitive Examination-III (ACE-III), at an average of 24.5 months post-illness. Bivariate analyses evaluated differences by sex and intensive care unit (ICU) admission. Multivariable linear regression was used to examine associations between cognitive scores and age, sex, education, socioeconomic status, ICU admission, body mass index, smoking exposure, hypertension, and diabetes. Results:We included 152 patients; the mean age was 56 years, and 58.5% were male. Anxiety symptoms were present in 33%, depression in 49%, and both perceived stress and cognitive dysfunction were each observed in 11% of patients. Women exhibited significantly higher levels of depression (P = 0.02) and stress (P = 0.011), whereas patients admitted to the ICU demonstrated greater cognitive impairment (P < 0.001). In multivariable regression, male sex (P = 0.002), higher education (P < 0.001), and hypertension (P = 0.037) were significantly associated with higher ACE-III scores, while ICU admission was associated with lower scores (P = 0.017). Conclusion:Our study reveals a high prevalence of mental health symptoms and cognitive dysfunction among patients 2 years after severe COVID-19. Anxiety showed no differences by sex or ICU requirement. Women exhibited higher rates of depression and perceived stress, while ICU admission was associated with poorer cognitive performance. Our findings should encourage systematic screening, diagnosis, and management of long-term neuropsychiatric sequelae in COVID-19 survivors. However, due to the limitations of the single-center design, further longitudinal and multicenter studies are warranted to better elucidate the long-term psychiatric impact of COVID-19.
Introduction. Viral, bacterial, and fungal infections represent a major health concern, contributing significantly to increased morbidity and mortality in respiratory diseases. Objective. To characterize respiratory infections and their etiological agents in patients admitted to intensive care units during the first six months of 2024. Materials and methods. An observational, cross-sectional, prospective study was conducted in two hospitals between January 1st. and June 30th., 2024. Clinical and microbiological data were collected (dates, age, sex, type of sample, results, and diagnoses) and analyzed using IBM SPSS™ Statistics 27.0. Results. Of the 56 patients admitted, 35 presented respiratory infections, predominantly in females, with a mean age of 49 years. The following agents were identified: rhinovirus/enterovirus, influenza A, coronavirus, parainfluenza, and respiratory syncytial virus. Among the most frequent bacteria found were: Klebsiella pneumoniae, Acinetobacter baumannii, Staphylococcus aureus, Pseudomonas aeruginosa, Haemophilus influenzae, Enterobacter cloacae, Escherichia coli, Proteus spp., Stenotrophomonas maltophilia, Serratia marcescens, Streptococcus agalactiae and S. pneumoniae. Bacterial resistance genes such as CTX-M, KPC, mecA/mecC, and MREJ, NDM, Oxa48-like, and VIM were also detected. In the case of fungal infections, Candida albicans and Candida glabrata were isolated. Most patients with respiratory illness progressed to hospital-acquired pneumonia. Conclusion. During the study period, respiratory infections in the intensive care units were mainly associated with bacterial pathogens, with a high frequency of hospital-acquired pneumonia and the detection of antimicrobial resistance genes.
Malignant hypertension is a medical emergency characterized by severe elevation in blood pressure with end-organ damage, including ocular involvement. Systemic lupus erythematosus (SLE) may result from lupus nephritis or vascular involvement in patients, and reports of severe hypertensive retinopathy in this setting are extremely limited. Herein, we report the case of a 30-year-old woman with SLE and poorly controlled chronic hypertension who presented with sudden bilateral vision loss. Ophthalmologic examination revealed grade IV hypertensive retinopathy with macular star exudates, a finding not previously described in similar reported cases. Optical coherence tomography demonstrated intraretinal hyperreflective deposits at the fovea without active macular edema, and fluorescein angiography showed areas of retinal ischemia. Intensive antihypertensive therapy and immunosuppressive treatment led to systemic stabilization but limited visual recovery. Only two similar cases have been reported, all presenting with hypertensive emergency, active SLE, and visual symptoms; however, the present case uniquely exhibited a macular star pattern. Early ophthalmologic recognition is essential for diagnosis, prognosis, and multidisciplinary management.
Introduction:Heart failure (HF) is a leading cause of hospitalization and mortality worldwide, emphasizing the critical role of optimal medical therapy (OMT) in improving patient outcomes. Despite extensive research, most scientific evidence regarding HF is gathered and studied in developed countries, leaving substantial knowledge gaps regarding HF in Latin America and the Caribbean. Objective:To characterize the sociodemographic and clinical profiles of HF patients and to assess their adherence to OMT in the Americas. Methods:The AMERICCAASS Registry is a prospective, observational, multicenter study, including patients aged 18 and older, both hospitalized and ambulatory, and diagnosed with HF. Sociodemographic and clinical data were collected from the first 2,500 patients to characterize the study population. Adherence to OMT was subsequently evaluated according to left ventricular ejection fraction (LVEF). Results:Among the 2,500 patients in the study, 36% were hospitalized and 64% were ambulatory. The median ages of the patients were 66.9 (hospitalized) and 66.3 years (ambulatory). Males made up 60.8% of hospitalized and 59.3% of ambulatory patients. The majority had HF with reduced LVEF (≤40%): 60.7% for hospitalized and 58.5% for ambulatory. The New York Heart Association (NYHA) functional class II predominated among ambulatory patients (67.9%), while NYHA functional class III predominated among hospitalized patients (46.6%). Only 21% of patients with reduced LVEF were receiving quadruple therapy, whereas 12.3% of patients with mildly reduced LVEF (41-49%) were on this treatment. Conclusion:The findings demonstrate that the sociodemographic and clinical profiles of HF patients in the Americas are broadly consistent with international reports. However, the low use of OMT observed in this population underscores gaps in adherence to current guidelines. These results highlight the need for targeted strategies to improve pharmacological treatment adherence to optimize health outcomes in this region.
Objectives:SARS-CoV-2 primary affects the respiratory tract; however, evidence suggests the oral cavity can be involved in severe COVID-19 survivors. This study investigates factors associated with xerostomia in severe COVID-19 survivors from a Latin American cohort. Materials and methods:A prospective multicenter study from the Latin American Registry of Cardiovascular Disease and COVID-19, analyzed data on 272 severe COVID-19 patients from 7 institutions in 5 countries (Colombia, Dominican Republic, Ecuador, Argentina, and Paraguay). Long-term follow-up assessed demographics characteristics, comorbidities, lifestyle, cardiovascular complications, and oral health. Logistic regression in R software identified factors associated with xerostomia. Results:Xerostomia was reported in 20.6% of patients. Among affected individuals, 53.6% were female, while women represented 35.6% of those without the condition. In the overall cohort, the most common comorbidities were overweight/obesity (57.0%), hypertension (55.9%), and dyslipidemia (32.0%). Patients with xerostomia had higher rates of dyslipidemia (48.2% vs. 27.8%) and asthma/COPD (16.1% vs. 4.2%) compared to the group without xerostomia. In multivariable logistic regression, asthma/COPD (aOR: 5.14; 95% CI: 1.76-15.7), palpitations (aOR: 2.47; 95% CI: 1.04-5.94), and chest pain (aOR: 3.74; 95% CI: 1.67-8.43) were independently associated with xerostomia. Conversely, male sex was associated with lower odds of reporting xerostomia (aOR: 0.47; 95% CI: 0.24-0.89). Conclusion:These findings underscore the need for clinicians to actively assess oral health symptoms such as xerostomia in post-COVID care, particularly in patients with cardiopulmonary comorbidities and persistent systemic symptoms.
