1. Investigación

Al inicio de la pandemia COVID-19 muchos gobiernos impusieron el confinamiento domiciliario. Esta situación afectó a la rutina diaria y vida cotidiana, incluidos los niños. Valorar el impacto en los niños del confinamiento domiciliario, objetivando si hubo ansiedad, alteraciones somáticas o cambios conductuales. Se desarrolló un estudio observacional transversal en 2292 niños españoles utilizando un cuestionario anónimo web mediante dos escalas: menores de siete años, los progenitores respondieron un cuestionario diseñado por los investigadores; y niños con siete o más años respondieron la Escala de Ansiedad Manifiesta Infantil Revisada. Los niños con siete o más años, obtuvieron puntuaciones elevadas en el espectro de ansiedad, más los varones. Se encontraron valores significativamente altos en todos los aspectos de la ansiedad en niños que temían la infección o inestabilidad laboral familiar. Progenitores de menores de siete años manifestaron que el 56,3% de estos presentaban cuatro o más síntomas relacionados con la ansiedad, siendo los más frecuentes Rabietas, Cambios emocionales, Inquietud y Miedo a estar solo, este último con significación estadística. El número de síntomas fue significativo cuando alguien en el hogar padeció COVID-19. La pandemia COVID-19 y el confinamiento domiciliario causaron ansiedad, problemas conductuales y manifestaciones somáticas en la población pediátrica.

Como consecuencia de la paralización de la economía provocada por las medidas adoptadas para contener la pandemia sanitaria, en el Derecho español se han adoptado en diferentes ámbitos normas temporales y excepcionales dirigidas a paliar los efectos derivados de esta situación. Entre esas medidas excepcionales y temporales publicadas como consecuencia del COVID-19, en el ámbito concursal se sitúa, fundamentalmente, el Real Decreto-Ley 16/2020, de 28 de abril, de medidas procesales y organizativas para hacer frente al COVID-19 en el ámbito de la administración de justicia.

In 1999 the European Council celebrated in Helsinki, on a proposal by the Commission, made Türkiye a candidate country for EU membership. To make further progress in the process, several reforms, both political and economic, had to be implemented. The aim of this paper is twofold. First, to study the evolution of one of the leading macroeconomic indicators: unemployment. Secondly, through the estimation of dynamic econometric models, to analyze the possible differences in the evolution of unemployment in Türkiye and the EU27, depending on variables such as per capita income, population, inflation, investment, or public debt. Furthermore, what has been the effect that relevant events such as the Great Depression of 2008 and the pandemic have had on unemployment?

The latest global pandemic of all is the well-known COVID-19 pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and originated in the city of Wuhan in December 2019. The need to find treatments and immunization tools was crucial. Quantifying the levels, duration, and effectiveness of immune responses against SARS-CoV-2 in each country was decisive in establishing, for example, vaccination intervals or understanding the long-term effects on the population, as well as anticipating the risk of future infection outbreaks with the arrival of new variants. The main objective of this thesis was to establish the specific activation level of T cells focused on vaccination against SARS-CoV-2 in Spain by developing a rapid cellular test starting from a minimally processed sample, such as whole blood. Furthermore, this test was not only performed on healthy volunteers but also on a vulnerable cohort (long-term hemodialysis patients) and, in a heterologous vaccination scenario. Moreover, the levels of specific antibodies against the S protein of the virus in each individual were checked for comparison.

Background: Antibodies to lipids are part of the first line of defense against microorganisms and regulate the pro/anti-inflammatory balance. Viruses modulate cellular lipid metabolism to enhance their replication, and some of these metabolites are proinflammatory. We hypothesized that antibodies to lipids would play a main role of in the defense against SARS-CoV-2 and thus, they would also avoid the hyperinflammation, a main problem in severe condition patients. Methods: Serum samples from COVID-19 patients with mild and severe course, and control group were included. IgG and IgM to different glycerophospholipids and sphingolipids were analyzed using a high-sensitive ELISA developed in our laboratory. A lipidomic approach for studying lipid metabolism was performed using ultra-high performance liquid chromatography coupled to electrospray ionization and quadrupole time-of-flight mass spectrometry (UHPLC-ESI-QTOF-MS). Results: Mild and severe COVID-19 patients had higher levels of IgM to glycerophosphocholines than control group. Mild COVID-19 patients showed higher levels of IgM to glycerophosphoinositol, glycerophosphoserine and sulfatides than control group and mild cases. 82.5% of mild COVID-19 patients showed IgM to glycerophosphoinositol or glycerophosphocholines plus sulfatides or glycerophosphoserines. Only 35% of severe cases and 27.5% of control group were positive for IgM to these lipids. Lipidomic analysis identify a total of 196 lipids, including 172 glycerophospholipids and 24 sphingomyelins. Increased levels of lipid subclasses belonging to lysoglycerophospholipids, ether and/or vinyl-ether-linked glycerophospholipids, and sphingomyelins were observed in severe COVID-19 patients, when compared with those of mild cases and control group. Conclusion: Antibodies to lipids are essential for defense against SARS-CoV-2. Patients with low levels of anti-lipid antibodies have an elevated inflammatory response mediated by lysoglycerophospholipids. These findings provide novel prognostic biomarkers and therapeutic targets.

Background: As in many fields of medical care, the coronavirus disease 2019 (COVID-19) resulted in an increased uncertainty regarding the safety of allergen immunotherapy (AIT). Therefore, the European Academy of Allergy and Clinical Immunology (EAACI) aimed to analyze the situation in different countries and to systematically collect all information available regarding tolerability and possible amendments in daily practice of sublingual AIT (SLIT), subcutaneous AIT (SCIT) for inhalant allergies and venom AIT. Methods: Under the framework of the EAACI, a panel of experts in the field of AIT coordinated by the Immunotherapy Interest Group set-up a web-basedretrospective survey (SurveyMonkey®) including 27 standardized questions on practical and safety aspects on AIT in worldwide clinical routine. Results: 417 respondents providing AIT to their patients in daily routine answered the survey. For patients (without any current symptoms to suspect COVID-19), 60% of the respondents informed of not having initiated SCIT (40% venom AIT, 35% SLIT) whereas for the maintenance phase of AIT, SCIT was performed by 75% of the respondents (74% venom AIT, 89% SLIT). No tolerability concern arises from this preliminary analysis. 16 physicians reported having performed AIT despite (early) symptoms of COVID-19 and/or a positive test result for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Conclusions: This first international retrospective survey in atopic diseases investigated practical aspects and tolerability of AIT during the COVID-19 pandemic and gave no concerns regarding reduced tolerability under real-life circumstances. However, the data indicate an undertreatment of AIT, which may be temporary, but could have a long-lasting negative impact on the clinical care of allergic patients.

Vaccines are essential public health tools with a favorable safety profile and prophylactic effectiveness that have historically played significant roles in reducing infectious disease burden in populations, when the majority of individuals are vaccinated. The COVID-19 vaccines are expected to have similar positive impacts on health across the globe. While serious allergic reactions to vaccines are rare, their underlying mechanisms and implications for clinical management should be considered to provide individuals with the safest care possible. In this review, we provide an overview of different types of allergic adverse reactions that can potentially occur after vaccination and individual vaccine components capable of causing the allergic adverse reactions. We present the incidence of allergic adverse reactions during clinical studies and through post-authorization and post-marketing surveillance and provide plausible causes of these reactions based on potential allergenic components present in several common vaccines. Additionally, we review implications for individual diagnosis and management and vaccine manufacturing overall. Finally, we suggest areas for future research.

One of the main concerns facing societies today is unemployment, although its evolution is not the same in all economies. Moreover, it is one of the variables that can not only delay but also prevent real convergence between the Member States of the European Union. This is the reason why it is necessary to know the determinants of the evolution of the unemployment rate. The aim of this paper is to present an explanatory model of unemployment since the beginning of the 21st century in two Mediterranean economies, Greece and Cyprus, which have important historical, cultural and economic ties. The identification of variables that may influence unemployment makes it possible to determine wheth er the response of the Greek and Cypriot authorities to reduce it has been adequate.

Residents of nursing homes have been significantly affected by COVID-19 in Spain. The factors that have contributed to the vulnerability of this population are very diverse. In this study, physical agents, chemical pollutants, population density and different capacities of residences were analysed to understand their influence on the number of elderly people who have died in geriatric centres in different autonomous communities (AACCs) of Spain. A statistical analysis was carried out on the variables observed. The results show that many residences with a larger number of deaths were private, with some exceptions. Physical agents and pollutants were found to be determining factors, especially for the communities of Extremadura and Castilla–La Mancha, although the large number of factors involved makes this study complicated. The compromise between air quality and energy efficiency is of great importance, especially when human health is at stake.

El gran número de afectados por la infección por SARS-CoV-2 y la potencial gravedad de esta enfermedad hace necesario identificar precozmente aquellos pacientes con alto riesgo de evolución desfavorable. La COVID-19 es una enfermedad con afectación sistémica. Varios estudios han puesto de relieve que una respuesta inmunitaria anómala es el punto de partida de los fenómenos de hipercoagulabilidad, daño endotelial, macro y microtrombosis, que desencadenarían consecuencias mortales en los pacientes. Las poblaciones de glóbulos blancos (monocitos, linfocitos y neutrófilos), así como las plaquetas desempeñan un papel crucial en el fenómeno de inmunotrombosis descrito en esta enfermedad. El objetivo del estudio es aclarar si la valoración de cuatro cocientes obtenidos a partir de parámetros habituales de un análisis de sangre (recuentos de estirpes leucocitarias y plaquetas) al ingreso en el hospital, así como la evolución de los mismos, puede ayudar a identificar a los pacientes con formas más severas de la enfermedad que necesitarán cuidados críticos. Los 4 ratios derivados del hemograma estudiados resultaron ser factores de riesgo de ingreso en UCI. La elevación durante el ingreso del ratio neutrófilo-linfocito, del ratio neutrófilo-plaqueta y del índice de inmunidad-inflamación sistémica aumentó el riesgo de ingreso en UCI. El ratio neutrófilo-plaqueta es el ratio del hemograma con mayor solidez de predicción del ingreso en UCI.