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.

The use of Sankey plots shows a fluctuating evolution of post-COVID brain fog, memory loss, or concentration loss during the first years after the infection. In addition, exponential bar plots revealed a decrease in the prevalence of these symptoms during the first years after hospital discharge. No risk factors were identified in this cohort.

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.

The declaration of the state of alarm in Spain on 13 March 2020 as a result of the COVID-19 pandemic led to the application of exceptional measures provided for in the legal system to deal with situations of great complexity and danger, in this case for the health and health system of the country. One of the measures adopted by the government was the limitation of movement of people, as well as the closure of places and services, in order to avoid crowds or encounters that could facilitate the transmission of the virus. Religious freedom has been affected by these measures, as far as the suspension of religious ceremonies and the mobility restrictions imposed on citizens have impaired the normal expression or exercise of religious freedom. In this paper the author analyzes the regulations that have affected the right of religious freedom and how it has been applied during the months of the state of emergency and then during the period of transition to the so-called 'new normality'

Coping style represents the cognitive and behavioral patterns to manage particular demands appraised as taxing the resources of individuals. Studies report associations between certain coping styles and levels of adjustment of anxious symptomatology and emotional distress. The main objective of this study was to analyze behavioral co-occurrent patterns and relationships in the coping strategies used to deal with psychological distress displayed by the Spanish adult population during the first State of Emergency and lockdown of the COVID-19 pandemic. This is a cross-sectional study that uses selective methodology complemented with an indirect observational methodology, with a nomothetic/punctual/unidimensional design. We collected 996 surveys from 19 out of the 22 autonomous regions in Spain. We focused the analysis on sociodemographic variables, cumulative incidence of the COVID-19 disease and psychological distress variables. We performed two different inferential analyses: Lag sequential analysis to define the participant coping patterns, and polar coordinate analysis to study the interrelationship of the focal behavior with conditioned behaviors. We found behavioral co-occurrent patterns of coping strategies with problem avoidance being found as the coping strategy most frequently engaged by participants. Interestingly, the problem avoidance strategy was not associated with lower anxious symptomatology. By contrast, emotionfocused strategies such as express emotions and social support were associated with higher anxious symptomatology. Our findings underscore the importance of furthering our understanding of coping as a way to aid psychological distress during global public health emergencies.