Asunto(s)
Anisoles , Antiarrítmicos , Fibrilación Atrial , Cardioversión Eléctrica , Servicio de Urgencia en Hospital , Flecainida , Pirrolidinas , Fibrilación Atrial/tratamiento farmacológico , Humanos , Flecainida/uso terapéutico , Antiarrítmicos/uso terapéutico , Antiarrítmicos/efectos adversos , Anisoles/uso terapéutico , Pirrolidinas/uso terapéutico , Pirrolidinas/efectos adversos , Pirrolidinas/administración & dosificación , Masculino , Femenino , Anciano , Resultado del Tratamiento , Persona de Mediana EdadAsunto(s)
Adhesión a Directriz , Humanos , Masculino , Femenino , Adulto , Persona de Mediana Edad , Intoxicación/terapia , Intoxicación/diagnóstico , Guías de Práctica Clínica como Asunto , Compuestos de Litio/envenenamiento , Diálisis Renal , Litio/envenenamiento , Litio/sangre , Antimaníacos/envenenamientoRESUMEN
BACKGROUND: Proper identification of patients at risk of developing serious disease in the context of SARS-CoV-2 infection, as well as the initiation of early treatment, is one of the fundamental elements for successful management of COVID-19. The main objective of this study was to evaluate the usefulness of serum biomarkers (neutrophils, lymphocytes, C-reactive protein, lactate dehydrogenase, D-dimer, ferritin, and interleukin-6) to predict the early response to immunosuppressant therapy in COVID-19 patients. METHODS: This is a case-control study nested in a retrospective cohort, which included hospitalized patients with interstitial pneumonia and with elevation of some proinflammatory parameters. Each of the individuals who died during the 28-day follow-up was defined as a case. For each case, 4 controls were selected, matched by age, gender, and comorbidities. RESULTS: The initial cohort included 856 patients. The incidence of therapeutic failure in the cohort was 14%, thus we identified a total of 120 cases. After the application of a Cox regression model, high serum concentrations of LDH (> 451 IU/L), ferritin (> 1,014 ng/mL) and D-Dimer (> 1,300 ng/mL) were identified as predictors of poor response to treatment. Highly-specific cut-off points could not be established for any of these biomarkers. CONCLUSIONS: Some inflammatory biomarkers, such as LDH, ferritin, and D-dimer, may be helpful in identifying patients for whom an early immunomodulatory therapeutic intervention should be considered in the treatment of COVID-19 patients with pneumonia.
Asunto(s)
Tratamiento Farmacológico de COVID-19 , Biomarcadores , Proteína C-Reactiva/análisis , Estudios de Casos y Controles , Ferritinas , Humanos , Factores Inmunológicos/uso terapéutico , Inmunosupresores/uso terapéutico , Interleucina-6 , L-Lactato Deshidrogenasa , Estudios Retrospectivos , SARS-CoV-2RESUMEN
BACKGROUND: The COVID-19 pandemic has caused global changes that affect the daily life of the world's population, with a direct impact on individuals' physical and mental health as well as on their social and recreational habits. METHODS: This study aimed to retrospectively analyze the demographic and clinical characteristics of patients attended to for acute poisoning in a hospital emergency department (ED) at three different periods of time: pre-pandemic (2019), after strict lockdown of the population in Spain (2020), and post-pandemic (2021). We analyzed 2 months (June and July) in each period. RESULTS: A total of 1,182 cases of acute poisoning were included. Compared to the pre-pandemic period, during lockdown, the number of patients with acute poisoning decreased (2019: 1.9% vs. 2020: 1.5%; pâ¯<â¯0.01); the ratio of men to women increased (2.0 vs. 1.4; pâ¯=â¯0.02); and the mean age of patients increased (2019: 31.4 vs. 2020: 41.3; pâ¯<â¯0.001), a trend which continued in 2021 (38.3). Poisoning with suicidal intention also increased during the pandemic (2019: 8.71% vs. 2020: 21.0%; pâ¯<â¯0.01) whereas poisonings with a recreational intention declined (2019: 76.1% vs. 2020: 62.0%; pâ¯<â¯0.01) with a non-significant increase in 2021 (69.0%, pâ¯=â¯0.07). CONCLUSION: The COVID-19 pandemic generated clinical and epidemiological changes in the acute poisonings attended to in a hospital emergency department during the various phases of the pandemic.
Asunto(s)
COVID-19 , Pandemias , COVID-19/epidemiología , Control de Enfermedades Transmisibles , Servicio de Urgencia en Hospital , Femenino , Humanos , Masculino , Estudios RetrospectivosRESUMEN
Background: The COVID-19 pandemic has caused global changes that affect the daily life of the world's population, with a direct impact on individuals' physical and mental health as well as on their social and recreational habits. Methods: This study aimed to retrospectively analyze the demographic and clinical characteristics of patients attended to for acute poisoning in a hospital emergency department (ED) at three different periods of time: pre-pandemic (2019), after strict lockdown of the population in Spain (2020), and post-pandemic (2021). We analyzed 2 months (June and July) in each period. Results: A total of 1,182 cases of acute poisoning were included. Compared to the pre-pandemic period, during lockdown, the number of patients with acute poisoning decreased (2019: 1.9% vs. 2020: 1.5%; p<.01); the ratio of men to women increased (2.0 vs. 1.4; p=.02); and the mean age of patients increased (2019: 31.4 vs. 2020: 41.3; p<.001), a trend which continued in 2021 (38.3). Poisoning with suicidal intention also increased during the pandemic (2019: 8.71% vs. 2020: 21.0%; p<.01) whereas poisonings with a recreational intention declined (2019: 76.1% vs. 2020: 62.0%; p<.01) with a non-significant increase in 2021 (69.0%, p=.07). Conclusion: The COVID-19 pandemic generated clinical and epidemiological changes in the acute poisonings attended to in a hospital emergency department during the various phases of the pandemic.