Medicine and Health Sciences Commons^™

Understanding Vaccine Hesitancy: An Analysis Of Caregiver Influences On Pediatric Covid-19 Vaccination Decisions, Neiki Rokni, Shu Zhao Md, Matthew Nguyen, David Liu, Harrison Jordan Do, Jory Parson, Sidharth Sahni Do, Tanner Walsh Md, Ashley Henderson Md, Jennifer Higgins Md

Tower Health Research Day

No abstract provided.

Hypermetabolic Lymphadenopathy Following The Administration Of Covid-19 Vaccine And Immunotherapy In A Lung Cancer Patient: A Case Report, Shreya Tripathy, Nathaniel Alvarez, Shubham Jaiswal, Ryan Williams, Munaf Al-Khadimi, Sarah Hackman, William Phillips, Supreet Kaur, Sherri Cervantez, William Kelly, Josephine Taverna

Research Symposium

Background: Given the current climate of the pandemic, lung cancer patients are especially vulnerable to complications from severe acute respiratory syndrome coronavirus 2 infection. As a high-risk population group, these patients are strongly advised to receive coronavirus disease 2019 vaccination in accordance with Center for Disease Control and Prevention guidelines to minimize morbidity and mortality. In recent years, immunotherapy has taken a preeminent role in the treatment of non-small cell lung cancer with dramatic improvement in overall survival. Reactive lymphadenopathy following the administration of a coronavirus disease 2019 vaccination can confound the radiographic interpretation of positron emission tomography-computed tomography or …

Comparing The Trends Of Postpartum Depression Screening Scores During And Before The Covid-19 Pandemic, Elif S. Duran, Dung Dang, Tony Ogburn

Research Colloquium

Introduction: Postpartum depression includes major and minor depressive disorder affecting women in the time period after childbirth. The studies reviewed in our literature found that the COVID-19 pandemic has increased the risk of postpartum depression for women. Our study location, the Rio Grande Valley is one of the hardest hit locations by the COVID-19 pandemic in the United States. Our patient population is also one with the higher risk factors for postpartum depression. As such, we are expecting the psychological impact of the pandemic to be even more magnified and thus, actions need to be taken to support the vulnerable …

Acute Aseptic Meningoencephalitis Due To Covid-19 In An Otherwise Healthy Patient: A Case Report, Shyama Appareddy, Norma Moncayo, Ronkino T. Mccoy, Jared Sperling, George Huddleston, Raza L. Kahn

Research Colloquium

Several studies have shown the extrapulmonary manifestations of COVID-19 disease caused by the SARS-CoV2 virus. Although extrapulmonary manifestation to the heart, kidney, blood, and skin are common, neurological and cerebrovascular manifestations are rare with most of these cases being described in patients who also have the pulmonary manifestation of the disease. Here we present the case of an 18 year-old male with no prior history of respiratory symptoms who presented to the emergency department with altered mental status. Neurology was consulted and the patient was started empirical on ceftriaxone, vancomycin, dexamethasone, and acyclovir for meningoencephalitis. Urine drug screen, head CT, …

Aids-Associated Kaposi's Sarcoma Complicated With Covid-19, Adriana Saavedra-Simmons, Veronica Salazar

Research Colloquium

Introduction: Several studies have not found a significant increase in risk of poor outcomes in people with HIV (PWH) who are coinfected with COVID-19. However, the majority of PWH in the studies were stable with their highly active antiretroviral therapy (HAART) regimen. We present a case of AIDS-associated Kaposi’s sarcoma (KS) with superimposed COVID-19 infection.

Case Description: Our patient is a 21-year old Hispanic male with recent diagnosis of HIV-1 who presented to the ED with generalized facial swelling and right lower extremity edema associated with shortness of breath (SOB) and palpitations. He denied fever, chills, weight loss, chest pain, …

A Covid-19-Inspired Comprehensive Approach To Resident Wellness And 360-Degree Approach To Pandemic Preparedness And Disinfection Practices, Preet Gudimella, Unnam Nasir, Heidi Pareja

Research Colloquium

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) outbreak that had led to the coronavirus disease 2019 (COVID-19) pandemic caused stress for medical residents on the frontline. This motivated our team to implement changes in our residency program’s inpatient service. We approached resident wellness in a comprehensive manner. The changes we implemented at our site had crucial benefits for our inpatient teams. Not only did we implement conventional best practices on infection prevention, we also executed additional safety measures, addressed mental and physical health, and had COVID-19-specific skills training. Consequently, our residents were less stressed, better prepared, and more focused …

Multisystem Inflammatory Syndrome In Children (Mis-C): Is There A Relationship To Typhus?, Juliana Hager, Juliana Hager, Jacob Smith

Research Colloquium

The United Kingdom first reported in April 2020 a group of eight previously healthy children with a link to severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) that presented with systemic inflammation and multi-organ involvement, now named multisystem inflammatory syndrome in children (MIS-C). The Centers of Disease Control and Prevention (CDC) have reported over 1000 cases since the primary discovery as of October 2020 with 20 total deaths. [1] The clinical features of MIS-C have been previously compared to inflammatory syndromes including Kawasaki disease (KD) and toxic shock syndrome (TSS). We describe the clinical presentation and management for 3 pediatric cases with …

Ut Health Rgv Covid-19 Testing Report, Jefferson T. R. Chandler, Beatriz Tapia

Research Colloquium

Purpose: This health surveillance project's goal was to organize de-identified data received from UT Health RGV with the intent to provide timely reporting to testing sites and health affairs directors. We aimed to explore how testing rates differ between counties, testing sites and age groups from March 30 through August 7, 2020. We looked at different demographics and compared the positivity rates for each testing site. For this report, we will detail information for the pediatric population (ages 0-18).

Materials and Methods: A codebook and database were created with information about COVID-19 test data to formulate reports to the testing …

Supportive Care Team Challenges On The Border In The Pandemic, Meghana Rao, Andrew N. Dentino

Research Colloquium

Background: Hospice and Palliative Medicine (HPM) is a subspecialty of medicine, recognized in 2008 by the ABMS, with over 200 fellowship programs nationally. This Supportive Care Team (SCT) interprofessional paradigm of MD’s, NP’s, PA’s, MSW’s, Pharm.D.’s, chaplains, RN’s and therapists holistically cares for persons with advanced life-limiting illnesses.

UTRGV SOM and DHR Health, in extreme south Texas on the border with Mexico, inaugurated the HPM fellowship in 2019. Its current fellow began in 2021.

The intent of the fellowship was for care and services to flow uninterruptedly throughout the RGV. However, in early 2020 the world changed indelibly due to …

Catheter-Associated Urinary Tract Infections: Patient Characteristics, Treatment, And Clinical Outcomes In One South Texas Acute Care Hospital, Kimberly A. Ambrosini, Jose Campo Maldonado

Research Colloquium

Background: Catheter-associated urinary tract infections (CA-UTIs) account for 40 percent of nosocomial infections worldwide. Their elimination is at the forefront of quality improvement in one South Texas acute care hospital.

Methods: Over a period of 6 months, five CA-UTIs occurred in one South Texas acute care hospital. These cases were identified via regular surveillance by Infection Prevention staff and the Laboratory Department of the hospital. This research reviews patient age, sex, length of stay, bacteria contracted, appropriate antibiotic use, patient characteristics, and overall outcomes.

Results: Between the months of July and December 2021, 5 CAUTIs were contracted. Patients ranged in …

E-Cigarette Or Vaping Use-Associated Lung Injury (Evali) In A Hispanic Male During The Covid-19 Pandemic, Juan C. Naranjo, Muhammad Jamal, Aramide Tijani, Fatimah Bello

Research Colloquium

Background: Electronic cigarette or vaping product use–associated lung injury established the relationship between vaping products and lung injury. Overlapping clinical manifestations may mimic those of other respiratory conditions including COVID-19. Multiple radiographic findings including diffuse, bilateral, ground-glass infiltrates with lower-lobe predominance, eosinophilic pneumonia, and diffuse alveolar damage have been described. It is important to consider this as an alternative diagnosis, particularly in patients with respiratory symptoms and a history of vaping in the last 90 days due to increased risk of COVID-19 infection and worse outcomes.

Case presentation: A 25-year-old male with a history of polysubstance abuse and frequent E-cigarette …

A Simple Case Of Viral Myopericarditis Or A Complication Of Monoclonal Antibody Infusion?, Jose A. Rivera, Michael Menowsky

Research Colloquium

Background: Myocarditis has been a rare, but well-documented side effect of the mRNA-based vaccines against SARS-CoV-2 as well as a complication of viral infections including SARS-CoV-2. However, myopericarditis as a complication of monoclonal antibody infusion or as complication of allergic reaction to antibody infusions might be and underreported.

Case presentation: In this case, we report a 30-year-old man with a previous diagnosis of COVID infection 1 week prior to presentation, unvaccinated for SARS-CoV-2 who was referred from a monoclonal infusion center where he received casirivimab and imdevimab and 15 minutes after infusion began to complain of chills, chest pain, shortness …

Impact Of Academic Golden Weekend Initiative On Academic Success For An Internal Medicine Clerkship, Elif S. Duran, Maria A. Alvarenga, Stephanie Onyechi, Jose E. Campo Maldonado

Research Colloquium

Background: COVID-19 precautions led to a change in the number of protected weekends for the UTRGV Internal Medicine Clerkship, going from 2 protected weekends to none. The aim of Academic Golden Weekends during a fully inpatient clerkship has been to maximize the student experience by providing enough time to balance all the necessary components of the student experience. Starting April 26, 2021, all cohorts completing their Internal Medicine Clerkship as third-year medical students had 3 protected weekends.

Methods: Two surveys were created to compare the pre-intervention and post-intervention cohorts. The surveys focused on student satisfaction regarding the time they had …

Rational Design For The Recombinant Expression Of The Receptor Binding Domain Of Sars-Cov-2 Spike Glycoprotein, Luis Mario Rodriguez, Mario Alberto Rodriguez, Hugo A. Barrera-Saldaña, Rocio Marisol Martinez, Daniela Rodriguez

Research Symposium

Background: COVID-19 represents a significant threat to global human health. SARS-CoV-2, the etiologic viral agent, needs to be under-covered at the structural biology level to facilitate the rational design of diagnostic tests and vaccine candidates. SARS-CoV-2 Receptor Binding Domain of Spike protein (RBD-S) acts as the key to open the gate, to enter the cells during infection. Thus, it is a stronger candidate for designing effective antigens for vaccines and diagnostics. Here, we relied on the viral DNA codifying to RBD-S to use synthetic biology for optimizing the recombinant expression of this (rRBD-S) as a proof of concept of rational …

Pediatric Covid-19 Encephalitis, Nelson D. Gonzalez, Dustin Paul, Ana Almeda, Samuel Serna, Linette Linsangan

Research Symposium

Background: Neurologic complications of COVID-19 in the pediatric population have been reported in a limited number of reports. There have been reports of COVID-19-associated encephalitis in pediatric cases along with neuroimaging findings revealing involvement of some parts of the nervous system. We present the first case of pediatric severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) - associated encephalitis targeting the parietal lobes.

Case: A 14-year-old morbidly obese Hispanic male with no past medical history presented to the hospital for new onset seizures. Family reported exposure to his COVID-19 positive mother, a one-week history of fever, and a three-month history of …

Learners Engaging With Hispanic Communities To Address Covid19 Inequities By Developing A Cultural Competence Guide For Public Health Messaging, Madeline Elaine Huff, Molly Chapman, Chasity Collier, Giuiseppe Fonseca Badillo, Shuchita Jhaveri, Ayesha Khan, Sabrina R. Orta, Zuni Ortega, Lina Pedraza Sanchez, Maria Pesantez Borja, Rosalind Reyes, Daniela Santos Cantu, Chelsea H. Chang

Research Symposium

Introduction: The Rio Grande Valley (RGV) has the highest rates of obesity and diabetes nationwide which have compounded the impact of COVID-19. We propose addressing underlying mistrust and systemic racism through a resident-and-student-learner-led, community-engaged, educational public health campaign targeting the Hispanic community in the RGV.

Methods: Twelve students were provided interdisciplinary leadership skills in a community-engaged public messaging campaign covering issues of COVID-19 inequities. Learners used these skills to engage with clinic community partners in qualitative interviews regarding the patient population to guide the creation of a culturally competent public health messaging rubric for the Hispanic community.

Results: Pre-intervention survey …

Human Ipsc Derived Cardiomyocyte Model Reveals The Transcriptomic Bases Of Covid-19 Associated Myocardial Injury, Kashish Kumar, Satish Kumar, Erica De Leon, Joanne E. Curran, Sarah Williams-Blangero, John Blangero

Research Symposium

Background: Multi-organ complications have been the hallmark of severe COVID-19; cardiac injuries were reported in 20% to 30% of hospitalized COVID-19 patients, although the disease etiology remains poorly understood. This study leveraged genome-wide RNA-sequence data generated using induced pluripotent stem cell (iPSC) differentiated cardiomyocytes (CMs) and in vitro modeling of SARS-CoV-2 infection in CMs, to understand the molecular mechanisms of COVID-19 myocardial injuries for novel diagnostic and therapeutic development.

Methods: Raw RNA-sequence data sets, GSE165242 and GSE150392 were aligned to human genome assembly GRCh38 and gene expressions were quantified. Differentially expressed (DE) genes between experimental groups were identified using moderated …

Expanding Health Professional Education In The Rio Grande Valley During The Covid-19 Pandemic, Sabrina R. Orta, Samantha G. Alvarado, Shuchita Jhaveri

Research Symposium

Purpose: The COVID-19 Pandemic has prompted innovation in health professional education, such that learners are able to recognize and mitigate healthcare disparities in the outcomes of vulnerable populations. The objective of our project was to increase education on preventing, preparing for, and responding to COVID-19 and other locally prevalent infectious diseases that disproportionately affect RGV communities.

Description: This project had 3 goals: (1) provide learners with virtual patient-interaction simulations (2) provide interactive training modules on the identification, prevention, and treatment of infectious diseases affecting South TX and strategies to increase child vaccinations, and (3) provide learners an opportunity to coordinate …

Epidemiological Algorithm And Early Molecular Testing To Prevent Covid-19 Outbreaks In A Mexican Oncologic Center, Moises González-Escamilla, Diana C. Peréz-Ibave, Carlos H. Burciaga-Flores, Vanessa N. Ortiz-Murillo, Genaro A. Ramírez-Correa, Patricia Rodríguez-Niño, Rafael Piñeiro-Retif, Hazyadee F. Rodríguez-Gutiérrez, Orlando D. Solis-Coronado, Juan F. González-Guerrero, Oscar Vidal-Gutiérrez, María Lourdes Garza-Rodríguez

Research Symposium

Introduction: Prevention strategies and detection of latent COVID-19 infections in oncology staff and oncologic patients are essential to prevent outbreaks in a cancer center. In this study, we used two statistical predictive models in oncology staff and patients from the radiotherapy area to prevent outbreaks and detect COVID-19 cases.

Methods: Staff and patients answered a questionnaire (electronic and paper surveys, respectively) with clinical and epidemiological information. The data was collected through two online survey tools: Real-Time Tracking (R-Track) and Summary of Factors (S-Facts). According to the algorithm's models, cut-off values were established. SARS-CoV-2 qRT-PCR tests confirmed the algorithm's positive individuals. …

Covid-19 And Chronic Diabetes: The Perfect Storm For Reactivation Tb?, Genesis P. Aguillón-Durán, Ericka Prieto-Martinez, Doris Ayala, Juan Garcia Jr, John M. Thomas, Juan I. Garcia, Jordi B. Torrelles, Eder Ledezma-Campos, Blanca I. Restrepo

Research Symposium

Background: The Coronavirus disease 2019 (COVID-19) pandemic is predicted to have a net negative effect on tuberculosis (TB) control, with an estimated excess of 6.3 million tuberculosis cases and 1.4 million deaths by 2025. Programmatic issues like the lockdown of TB services affect all patients, while biosocial factors have a differential impact on an individual’s risk for TB or adverse TB outcomes.

Case presentation: We report three cases of incident TB after resolution of COVID-19 episodes.Coincidently, all cases shared a common risk factor: a chronic history poorly-controlled diabetes.

Conclusions: Our findings alert to the threat posed by …

Correlation Between Ct-Values And Symptoms Of Covid-19 Patients, Luis E. Fernández-Garza, A. Huitrón-Carrizales, Hugo A. Barrera-Saldaña, Raúl Rodríguez-Palacios

Research Symposium

Background: Currently available RT-PCR methods for the diagnosis of COVID-19 can give an estimate of the viral load. The cycle threshold value (Ct-value) of the PCR correlates inversely with the viral load; low Ct-values indicate high viral loads and vice versa. Higher viral loads have been seen to correlate with disease severity and infectivity. Therefore, we studied the correlation of the Ct-value of RT-PCR and the most common symptoms of COVID-19 individually.

Methods: A prospective and descriptive study was carried out with the subjects that attended our laboratory for a COVID-19 test from September 14, 2020, to January 30, 2021. …

Comparison Of Five Commercial Kits For Sars Cov 2 Rt-Pcr Diagnosis., Carolina Rivera, Hugo A. Barrera-Saldaña, Marisol Ramirez

Research Symposium

Background: SARS-CoV-2 was identified as the causal agent of the COVID-19 pandemic. Its rapid spread and huge health and economic impact prompted the development of diagnostic tests to opportunely identify affected individuals as a prerequisite to quarantine them and avoid further spreading the infection.

Methods: The following commercial RT-PCR kits, approved by our National Institute of Diagnostics and Epidemiological Reference of InDRE (from the Spanish name) were tested: Vircell (Granda, Spain), Light Mix Roche (Berlin, Germany), Logix Smart (Utah, USA), 1 Copy (Korea Republic), and RIDA GENE (Darmstadt, Germany). RNA was isolated either manually or automatically (QIAmp Viral RNA and …

Automated Versus Manual Rna Isolation For The Laboratory Diagnosis Of Sars-Cov-2., Raúl Rodríguez-Palacios, Nathalia L. Walle-Gloria, Daniela Rodríguez-Casir, Hugo A. Barrera-Saldaña

Research Symposium

Background: The rapid spread and huge health and economic impact witnessed even from the beginning of the COVID-19 pandemic prompted the development of diagnostic tests to opportunely identify individuals infected by its causing agent, the SARS CoV-2 virus. This is a prerequisite to quarantine them to avoid further spreading the infection specially to their vulnerable co-workers and family contacts. The golden standard for pathogen detection is the Polymerase Chain Reaction (PCR). To obtain an accurate result, it is important to carry out an optimal isolation of the viral RNA genome.

Methods: This study aimed to compare manual (kits of Qiagen …

A Survival Analysis Of High-Grade Gliomas In Sub-Himalayan Population Including The Times Of Lockdown During Covid 19 Pandemic: A Single Institutional Experience, Pooja Kalra, Meenu Gupta, Vipul Nautiyal, Ranjeet Kumar, Sanjeev Pandey, Nazia Shirazi, Brijesh Tiwari, Mushtaq Ahmad

Research Symposium

Background and Objectives: High Grade Gliomas are categorised as Grade III and IV and have high mortality rate with poor prognosis. How we should adopt clinical practice in neuro-oncology during Covid 19 Pandemic is another area of scientific exploration . Hypofractionated radiotherapy protocols can be easily utilised in high grade gliomas during Covid 19 pandemic .

Materials and Methods: Retrospective analysis of 147 patients with diagnosis of high-grade gliomas between January 2009 till December 2020 including Covid-19 pandemic lockdown time was done. Age , gender , KPS , symptoms , extent of surgery and use of concurrent temozolamide , were …

A Closer Look At Covid Testing Among The Pediatric Population Living Along The Texas-Mexico Border, Naba Asif, Jefferson Chandler

Research Symposium

Background & Objectives: On August 2020, the AAP reported that Texas only provides pediatric age distribution for 8% of COVID-19 testing results. In response to the limited data availability, our research focused on tracking test positivity rates for the pediatric population (ages 0-19) in the Rio Grande Valley from March 30 through August 7, 2020.

Methods & Analysis: The research study received IRB exemption status on August 9, 2020. We obtained deidentified data from UT Health RGV COVID testing sites in Hidalgo and Cameron county. SPSS was used to find the mean and median age and frequency over time of …

A Case Of Chronic Inflammatory Demyelinating Polyneuropathy After Pfizer Covid-19 Vaccination, Irma Duncan, Alexander S. Renpenning, Roberto A. Cruz

Research Symposium

Background: Chronic inflammatory demyelinating polyneuropathy is an immune-mediated polyneuropathy characterized by peripheral demyelination, resulting in symmetrical sensory loss and distal and proximal muscle weakness. While CIDP has been reported after influenza, tetanus, and other common vaccinations, this is the first reported case of CIDP after COVID-19 vaccination to our knowledge.

Case Presentation: A 34-year-old right-handed male with an unremarkable past medical history presented with bilateral distal paresthesias, proximal and distal muscle weakness, and fine motor difficulties. Symptoms initially manifested with toe numbness, approximately two weeks after receiving the first dose of the Pfizer COVID-19 vaccine. Paresthesias gradually progressed from …

A Dangerous Complication Of Acute Pancreatitis: Abdominal Compartment Syndrome, Paulina Vega Enriquez, Henry Kwang

Research Symposium

Abdominal compartment syndrome (ACS) is defined by an increased in intra-abdominal pressure (>20 mmHg) associated with new organ dysfunction. The mortality is reported to be approximately 50%, even with surgical abdominal decompression. Pancreatitis is a well-known risk factor of ACS and is associated with increased mortality and morbidity. We describe a COVID-19 positive patient, with recurrent acute pancreatitis secondary to hypertriglyceridemia, who developed ACS. Patients with this combination have critically elevated rates of mortality and morbidity, but fortunately our patient was discovered early and managed promptly.

Effect Of Confinement By Sars-Cov-2 On The Degree Of Steatohepatitis In University Students From Reynosa, Tamaulipas, Odalis I. Loredo, Maria Elena Aguilar-Peña, Marisol Rosas-Díaz, Adriana Leticia Perales-Torres, Esperanza M. García-Oropesa

Research Symposium

Introduction: Healthy lifestyles are relevant for several diseases, steatohepatitis, although little known, is common in young people. There are reasons to be concerned about homebound college youth who are at risk for steatohepatitis. By restricting the mobility of the population, the risk factors for weight gain and the intake of calorie-dense foods increase, which are elements associated with steatohepatitis.

Objective: To determine the effect of confinement during the COVID-19 pandemic on the degree of steatohepatitis by comparing transient elastography results taken before and after confinement.

Method: Longitudinal study. A sample of 114 young university students of random sex was included. …

Clinical Characteristics And Risk Factors For Mortality During The 'First Wave' Of Covid-19 In Reynosa, Tamaulipas, Luis G. Vargas Garcia, Francisco E. Díaz Cisneros, Antonio Gutiérrez Sierra, Juan Rosales Martínez, Manlio F. Lara Duck, Netzahualcoyotl Mayek Pérez

Research Symposium

Background: The COVID-19 pandemic has impacted public health in Mexico. As of February 2020, there have been at least four "waves" of contagion that resulted in 5.82 million positive cases and more than 325 thousand deaths. At the beginning of the COVID-19 pandemic, hospital and population-based information was available, frequently with non-specific symptoms. Little was known about the risk factors for mortality in specific conditions. We described the clinical characteristics of patients with COVID-19 in Reynosa, Tamaulipas during 2020 and identified the risk factors for mortality.

Methods: The COVID-19 cases registered from March to November 2020 in Reynosa were divided …

Neutralizing Anti-Rbd Fraction For Sars-Cov-2 Is Associated With The Interaction Waist Circumference And Sex. An Esfuerso Preliminary Report On University Students, Juan C. Lopez-Alvarenga, Esperanza M. Garcia-Oropeza, Adriana L. Perales-Torres, Alvaro Diaz-Badillo, Lucia M. Perez-Navarro, Estrella Martinez-Lopez, Marisol Rosas-Diaz, Octelina Castillo-Ruiz, Laura Yanneth Ramirez-Quintanilla, Jacquelynne Cervantes, Edda Sciutto, Beatriz Tapia, Leonel Vela, Claudia Munguia-Cisneros, Carlos Ramirez-Pfeiffer

Research Symposium

In a previous study we reported that 25% of college students had a family history of type 2 diabetes (T2D), and 39% of hypertension. Interestingly, between 17 to 47% reported not knowing about T2D or hypertension, neither the existing obesity-metabolic problems (ESFUERSO study). The COVID-19 pandemic forced confinement and modifications in food intake, physical activity, and psychological stress. This study aimed to analyze if the immune Ig-G anti-RBD (protective epitope in S protein) response associated with type of vaccination, metabolic risk, perceived stress, and history of COVID-19 contacts.

We included 116 students at the 3th year of follow up in …