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The ongoing COVID-19 pandemic has already caused over a million deaths worldwide, and this death toll will be much higher before effective treatments and vaccines are available. The causative agent of the disease, the coronavirus SARS-CoV-2, shows important similarities with the previously emerged SARS-CoV-1, but also striking differences. First, SARS-CoV-2 possesses a significantly higher transmission rate and infectivity than SARS-CoV-1 and has infected in a few months over 60 million people. Moreover, COVID-19 has a systemic character, as in addition to the lungs, it also affects the heart, liver, and kidneys among other organs of the patients and causes frequent thrombotic and neurological complications. In fact, the term "viral sepsis" has been recently coined to describe the clinical observations. Here I review current structure-function information on the viral spike proteins and the membrane fusion process to provide plausible explanations for these observations. I hypothesize that several membrane-associated serine proteinases (MASPs), in synergy with or in place of TMPRSS2, contribute to activate the SARS-CoV-2 spike protein. Relative concentrations of the attachment receptor, ACE2, MASPs, their endogenous inhibitors (the Kunitz-type transmembrane inhibitors, HAI-1/SPINT1 and HAI-2/SPINT2, as well as major circulating serpins) would determine the infection rate of host cells. The exclusive or predominant expression of major MASPs in specific human organs suggests a direct role of these proteinases in e.g., heart infection and myocardial injury, liver dysfunction, kidney damage, as well as neurological complications. Thorough consideration of these factors could have a positive impact on the control of the current COVID-19 pandemic.

The protective capacity and duration of humoral immunity after SARS-CoV-2 infection are not yet understood in solid organ transplant recipients. A prospective multicenter study was performed to evaluate the persistence of anti-nucleocapsid IgG antibodies in liver transplant recipients 6 months after coronavirus disease 2019 (COVID-19) resolution. A total of 71 liver transplant recipients were matched with 71 immunocompetent controls by a propensity score including variables with a well-known prognostic impact in COVID-19. Paired case-control serological data were also available in 62 liver transplant patients and 62 controls at month 3 after COVID-19. Liver transplant recipients showed a lower incidence of anti-nucleocapsid IgG antibodies at 3 months (77.4% vs. 100%, p <.001) and at 6 months (63.4% vs. 90.1%, p <.001). Lower levels of antibodies were also observed in liver transplant patients at 3 (p =.001) and 6 months (p <.001) after COVID-19. In transplant patients, female gender (OR = 13.49, 95% CI: 2.17-83.8), a longer interval since transplantation (OR = 1.19, 95% CI: 1.03-1.36), and therapy with renin-angiotensin-aldosterone system inhibitors (OR = 7.11, 95% CI: 1.47-34.50) were independently associated with persistence of antibodies beyond 6 months after COVID-19. Therefore, as compared with immunocompetent patients, liver transplant recipients show a lower prevalence of anti-SARS-CoV-2 antibodies and more pronounced antibody levels decline.

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Aquesta publicació s'elabora a partir de les contribucions de cadascú dels membres nacionals que integren la Network of Eurofound Correspondents. Pel cas d'Espanya la contribució ha estat realitzada per l'Alejandro Godino (veure annex 4 Network of Eurofound Correspondents) This report presents Eurofound's research on telework during the COVID-19 pandemic in 2020 and 2021. It explores changes in the incidence of telework, working conditions experienced by employees working from home and changes to regulations addressing issues related to this working arrangement. The findings reveal a rapid escalation of telework triggered by the pandemic: in 2021, 2 out of 10 European employees were teleworking - a figure that most likely would not have been reached before 2027 had the pandemic not occurred. The health crisis unleashed the social and technological potential for flexibility in terms of working time and place. The impacts of telework on working conditions were initially difficult to determine because it was difficult to disentangle them from pandemic-induced factors, such as lockdowns and school closures. However, both the positive impacts, such as the contribution of telework to improving work-life balance, and the negative impacts, such as reduced social interaction and an increase in overtime worked, have become more evident. The rise in telework and an awareness of its implications for working conditions have prompted a renewed focus on regulatory frameworks, with new telework regulations passed in several EU Member States

Most children with SARS-CoV-2 infection have relatively mild clinical symptoms without fever or pneumonia, although severe cases with multiple-organ failure have been reported. Neurological symptoms, which have been mainly reported in adults, are very rare in children. This article will review 2 different aspects of neurological involvement related to this infection in children. In the first part, we will review the neurological abnormalities reported in children caused by this viral infection. Adults frequently report muscle pain, headache, anosmia, dysgeusia, and occasionally more severe central or peripheral nervous system damage. Neurological involvement seems infrequent in children, although some cases have been reported. In the second part, we will discuss the COVID-19 pandemic impact on the healthcare system of some countries, causing collateral damage to general pediatric care and in particular to those children affected with chronic diseases, mainly neurological conditions, including autism, intellectual disability, attention deficit and hyperactivity disorder (ADHD), neuromuscular disorders, cerebral palsy, and epilepsy, and patients needing neurosurgical procedures.

The COVID-19 pandemic has exacerbated digital inequalities and brought new attention to the digital divide, which has become a criticaltopic for social justice. In the context of school closures, along with more traditional methods of distance learning, emerging technologies like mobile phones and the accessibility of certain platforms, like WhatsApp, filled the immediate need to serve as a primary teaching and learning tool. Albeit WhatsApp had already been used in different contexts as a supporting tool for learning, this was the first time WhatsApp became the classroom. Considering that potentially learning will move to a hybrid space in the near future -given the escalation of the climate crisis and ongoing conflicts worldwide -it be comes necessary to understand how the distance education process unfolds in vulnerable contexts, what is the student experience with this type of learning, and what learning culture is fostered under determined conditions of access. The lack of consideration of these aspects could increase education inequalities which will, of course, impact vulnerable students the most. Following aconstructivist approach, I designed a qualitative single case study using focus groups, emoji-elicitation techniques,and in-depth interviews. Using a quasi-participatory approach, I worked with a purposeful sample of 22 female secondary school students from rural backgrounds in the southern Peruvian Andes. Using a learning cultures framework and the concept of the digital divide, especially its type of technology determinant, I sought to describe the features of the WhatsApp classroom and how this learning culture was expressed in the actions, emotions and learning of female students from vulnerable backgrounds. The learning cultures framework allowed the exploration of what types of learning were made possible and which were impossible in the WhatsApp learning culture. Seemingly, a WhatsApp learning culture will allow for the retention of students and for them to feel safer and thus more eager to communicate and participate. At the same time, the configuration of the learning culture will disallow the interaction between actors (peers and teachers), the possibility of asking questions in an appropriate time frame and the in-depth comprehension of subjects, impacting significant learning. Following the main discussions, a small section is devoted to thinking beyond the walls of the WhatsApp classroom and into the potential other applications and configurations using the same device might have in aiding learning

The new severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has been an unprecedented global health problem, causing more than 20 million infections and more than 900,000 deaths (September 2020). The SARS-CoV-2 infection, known as COVID-19, has various clinical presentations, from asymptomatic or mild catarrhal processes to severe pneumonia that rapidly progresses to acute respiratory distress syndrome (ARDS) and multiple organ failure. In the last few months, much scientific literature has been devoted to descriptions of different aspects of the coagulation disorders and arterial and venous thrombotic complications associated with COVID-19, particularly venous thromboembolism (VTE). These studies have revealed that SARS-CoV-2 could lead to a prothrombotic state reflecting the high cumulative incidence of associated thrombotic events, particularly in patients admitted to intensive care units (ICUs). As regards the coagulopathy observed in association with SARS-CoV-2 infection, the mechanisms that activate coagulation have been hypothesized as being linked to immune responses, through the release of pro-inflammatory mediators that interact with platelets, stimulate the expression of tissue factor, induce an upregulation of plasminogen activator inhibitor-1, suppress the fibrinolytic system and lead to endothelial dysfunction, triggering thrombogenesis. D-dimer elevation has been recognized as a useful biomarker of poor prognosis, although the best cut-off point for predicting VTE in COVID-19 patients has still not been clarified. This review will try to update all the available scientific information on this important topic with enormous clinical and therapeutic implications.

Altres ajuts: Agencia Nacional de Investigation y Desarrollo (ANID), Chile (COVID0700). In the context of a pandemic, the rapid development of clinical practice guidelines (CPGs) is critical to guide dental staff towards the safe provision of dental care; detailed knowledge of the recommendations will help to achieve the intended results. We carried out a systematic review of the recommendations in clinical practice guidelines (CPGs) on the provision of dental care issued during the first year of the COVID-19 pandemic. A systematic database search was performed in MEDLINE, EMBASE, LILACS, Epistemonikos, and Trip databases to identify documents with recommendations intended to minimize the risk of COVID-19 transmission during dental care. The selection process and data extraction were carried out by two researchers independently. The majority of CPGs recommended the use of rubber dam, high-volume evacuator, mouthwash prior to dental care, four-handed work, and mechanical barriers. The use of aerosol-generating equipment should be avoided whenever possible. In aerosol-generating procedures, the use of a N95 respirator (or similar) is recommended, in addition to a face protector, an impermeable disposable apron/gown, a cap, and gloves. The CPGs developed during the first year of the pandemic offer recommendations which guide dental staff in providing safe dental care, minimizing exposure to SARS-CoV-2 and reducing the risk of COVID-19 infection in the clinical environment. Such recommendations must, however, be updated as new evidence arises.

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