Introduction: Until April 20 in Ecuador there were 10,122 confirmed cases of Covid-19 with 507 deaths. We described the clinical characteristics of 115 confirmed Covid-19 cases. Methods: Nasopharyngeal swab or tracheal aspirate samples were collected to perform a confirmatory test for Covid-19. Clinical, laboratory and chest radiography data, invasive mechanical ventilation, days of hospitalization and number of deaths were recorded. Results: The mean was 54.1 years with 59% male. 96.5% had Dyspnea being the most frequent symptom and 20% had diarrhea. Hypertension and Diabetes Mellitus were the main comorbidities. The mean until death was 15.3 days with 9.2 days of hospitalization. 40.9% required invasive mechanical ventilation. 48.7% recovered, 9.6% remain hospitalized and 41.7% died. X-ray showed bilateral opacity. 46.9% had leukocytosis and 85.5% of the deceased presented lymphopenia versus 53.7% of the survivors (p<0.001). 77.4% with prolonged prothrombin time and 82.6% elevated lactic dehydrogenase. Discussion: Respiratory symptoms are the most frequent. However, the presence of diarrhea was greater than previously reported suggesting the importance of investigating gastrointestinal disorder as the primary symptom. The fatality rate was 41.7%, like critically ill patients. The age of the deceased was older than the survivors, being 62.5% male and 52.1% with some comorbidity, both considered risk factors for severe forms of Covid-19. Lymphopenia is a critical factor associated with severity and mortality.

Exophiala is a heterogeneous genus implicated in a variety of illnesses. The aim was to investigate the presence of Exophiala species in the gastrointestinal tract from a pediatric population. Strains from stool samples were isolated and identified by sequencing internal transcribed spacer region. Results showed a prevalence of 13% of Exophiala dermatitidis. This is the first report of E. dermatitidis in the gastrointestinal microbiota from a pediatric population in a Latin-American country.

Alterations in the immune system are often found in children with Autism Spectrum Disorders [ASD], leading to an aberrant immune response which compromises host defense. Fewer regulatory T-cells, elevation in inflammatory cells and proinflammatory cytokines have been highly reported in this population and it has been recently seen as a chronic neuroinflammatory disorder. Cytokines are often dysregulated in ASD especially IL-6, which is one of the biggest concerns during the current COVID-19 pandemic, as well as other immune dysregulations. We strongly believe that this proinflammatory environment in ASD could increase the vulnerability of a poor clinical outcome for COVID-19 infection.