The knowledge of physicians and nurses on advance directives is low, so it is necessary to improve this knowledge. Physicians and nurses from both levels show positive attitude towards the use and usefulness and respect the contents of advance directive. The methodology proposed is efficient to implement in a larger study, but should improve the distribution and collection of questionnaires.

Objective: To evaluate the factors associated with false negatives in RT-qPCR in patients with mild-moderate symptoms of COVID-19. Materials and methods: This was a cross-sectional study that used a random sample of nonhospitalized patients from the primary care management division of the Healthcare Area of Leon (58 RT-qPCR-positive cases and 52 RT-qPCR-negative cases). Information regarding symptoms was collected and all patients were simultaneously tested using two rapid diagnostic tests ---RDTs (Combined ---cRDT and Differentiated ---dRDT). The association between symptoms and SARS-CoV-2 infection was evaluated by non-conditional logistic regression, with estimation of Odds Ratio. Results: A total of 110 subjects were studied, 52% of whom were women (mean age: 48.2 ± 11.0 years). There were 42.3% of negative RT-qPCRs that were positive in some RDTs. Fever over 38 • C (present in 35.5% of cases) and anosmia (present in 41.8%) were the symptoms most associated with SARS-CoV-2 infection, a relationship that remained statistically significant in patients with negative RT-qPCR and some positive RDT (aOR = 6.64; 95%CI = 1.33---33.13 and aOR = 19.38; 95% CI = 3.69---101.89, respectively). Conclusions: RT-qPCR is the technique of choice in the diagnosis of SARS-CoV-2 infection, but it is not exempt from false negatives. Our results show that patients who present mild or moderate

Pregnant women who have COVID-19 have an increased risk of hospitalization and death; however, there are many restrictions for the application of COVID-19 vaccines on pregnant patients, mainly because there is no confirmation of the safety of their use during pregnancy. None of the vaccines approved to date are based on live attenuated SARS-CoV-2, so the possibility of generating an infection in the fetus is nonexistent.

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