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Emerging evidence suggests that mental health symptoms in COVID-19 survivors are higher than expected, possibly indicating that such symptoms are more likely to develop post-infection than just persist as a residual component of the acute phase. It is thus imperative to investigate the potential development of a post-COVID mental health syndrome in the longer-term and identify its risk factors.A prospective study investigated mental health symptoms associated with COVID-19 and its determinants over a 12-month period following the disease onset in all consecutive adult inpatients and outpatients with COVID-19 attending a tertiary referral hospital from March to May 2020.A total of 479 patients (female, 52.6%) were followed-up for 12 months after COVID-19 onset. Of them, 47.2% were still presenting with at least one symptom. While most symptoms subsided as compared to COVID-19 onset (allFindings of this study may have important public health implications, as they underlie the increased need for mental health support in COVID-19 survivors.Nuevas evidencias sugieren que los síntomas de salud mental en los supervivientes de COVID-19 son mayores de lo esperado, lo que posiblemente indica que es más probable que dichos síntomas se desarrollen después de la infección en vez de sólo persistir como componente residual de la fase aguda. Por lo tanto, es imperativo investigar el posible desarrollo de un síndrome de salud mental post-COVID a largo plazo e identificar sus factores de riesgo.Un estudio prospectivo investigó los síntomas de salud mental asociados a la COVID-19 y sus determinantes durante un periodo de 12 meses tras el inicio de la enfermedad en todos los pacientes adultos consecutivos con COVID-19, hospitalizados y ambulatorios, que acudieron a un hospital de tercer nivel entre marzo y mayo de 2020.Un total de 479 pacientes (mujeres, 52,6%) fueron seguidos durante 12 meses después del inicio de COVID-19. De ellos, el 47,2% seguía presentando al menos un síntoma. Mientras que la mayoría de los síntomas disminuyeron en comparación con el inicio de la COVID-19 (todos p 0,001), se observó un aumento significativo solamente de los síntomas de los trastornos psiquiátricos (10,2%) y la falta de concentración y enfoque (20%; todos p 0,001). Los pacientes que presentaban síntomas relacionados con múltiples sistemas del cuerpo 12 meses después de contraer la COVID-19 (todos p ≤ 0,034) tenían más probabilidades de sufrir síntomas relacionados con el dominio de la salud mental en el seguimiento. Además, se encontró un mayor riesgo de presentar falta de concentración y enfoque 12 meses después de la infección en los que sufrían síntomas psiquiátricos al inicio de COVID-19 (p = 0,005).Los resultados de este estudio pueden tener importantes implicaciones para la salud pública, ya que subyacen a la mayor necesidad de apoyo a la salud mental de los supervivientes de COVID-19.

Background Linezolid-induced myelosuppression limits optimal therapy in cardiosurgical patients with deep-seated infections at current doses. Methods Adult patients who received a cardiac surgery intervention and linezolid for a documented or presumed serious gram-positive infection were evaluated. Therapeutic monitoring data, dosing, concomitant medications, and other pertinent laboratory data were collected retrospectively. A population pharmacokinetic model was constructed to identify covariates and test potential drug–drug interactions that may account for interpatient variability. Simulations from the final model identified doses that achieve a target therapeutic trough concentration of 2–8 mg/L. Results This study included 150 patients (79.3% male) with sepsis and hospital-acquired pneumonia in 71.7% as the primary indication. The population had a median (minimum–maximum) age, body weight, and estimated glomerular filtration rate (eGFR) of 66 (30–85) years, 76 (45–130) kg, and 46.8 (4.9–153.7) mL/minute, respectively. The standard linezolid dosage regimen achieved the therapeutic range in only 54.7% of patients. Lower-than-standard doses were necessary in the majority of patients (77%). A 2-compartment Michaelis-Menten clearance model with weight, kidney function, and the number of interacting drugs identified as covariates that best fit the concentration-time data was used. Cyclosporine had the greatest effect on lowering the maximum elimination rate (Vmax) of linezolid. Empiric linezolid doses of 300–450 mg every 12 hours based on eGFR and the number of interacting medications are suggested by this analysis. Conclusions Lower empiric linezolid doses in cardiosurgical patients may avoid toxicities. Confirmatory studies are necessary to verify these potential drug interactions.

The COVID-19 pandemic emotionally affected the lives of patients cared for in different settings. However, a comprehensive view of the whole experience as lived by survived patients, from the onset of the disease and over time, is substantially unknown to date. A descriptive qualitative design was implemented according to the Standards for Reporting Qualitative Research. Adult patients (=1067) cared for during the first wave (March/April 2020) capable of answering an interview and willing to participate were interviewed (=397) by phone with an interview guide including open- and closed-ended questions. In this context, they were asked to summarise with a metaphor their entire COVID-19 experience at six months. Then, the emotional orientation (positive, neutral, or negative) of the metaphors expressed was identified. The participants were mainly female (206; 51.9%), with an average age of 52.6 years (CI 95% 50.4–53.6), reporting a mild severity of COVID-19 disease at the onset (261; 65.7%) and the perception of being completely healed (294; 70%) at six months. The patients summarised their experiences mainly using negative-oriented (248; 62.5%) metaphors; only 54 (13.6%) reported positive-oriented metaphors and a quarter (95; 23.95) neutral-oriented metaphors. Nearly all positive-oriented metaphors were reported by patients with symptoms at the onset (53; 98.1%), a significantly higher proportion compared to those reporting negative- (219; 88.3%) and neutral–oriented (78; 82.1%) metaphors (p = 0.014). While no other clinical features of the disease were associated, among females, significantly more negative-oriented metaphors emerged. Moreover, neutral-oriented metaphors were reported by younger patients (49.5 years, CI 95% 64.11–52.92) as compared to those negative and positive that were reported by more mature patients (53.9; CI 95% 52.04–55.93 and 54.8; CI 95% 50.53–59.24, respectively) (p = 0.044). Nurses and healthcare services require data to predict the long-term needs of patients. Our findings suggest that, for many patients, the COVID-19 lived experience was negative over time.