Impact effects of COVID-19 pandemic on chronic disease patients: A longitudinal prospective study.

AIMS: To assess the effects of COVID-19 pandemic on clinical variables as part of the routine clinical monitoring of patients with chronic diseases in primary care. DESIGN: A prospective longitudinal study was conducted in primary care centres of the Andalusian Health Service. METHODS: Data were recorded before the pandemic (T1), during the declaration of the state of emergency (T2) and in the transition phase (T3). The Barthel index and the Short Portable Mental Status Questionnaire (SPMSQ) were used to analyse functional and cognitive changes at the three time points. HbA1c, systolic and diastolic blood pressure, heart rate, BMI and lipid levels were assessed as clinical variables. Descriptive statistics and non-parametric chi-square test were used for analysis. STROBE checklist was used for the preparation of this paper. RESULTS: A total fo148 patients with chronic conditions were included in the analysis. Data analysis revealed in T2 only significant reductions in BMI, total levels of cholesterol and HDL during the onset of the pandemic. Barthel Index, SPMSQ, blood pressure and triglycerides and LDL levels worsened in T2, and the negative effects were maintained in T3. Compared to pre-pandemic values, HbA1c levels improved in T3, but HDL levels worsened. CONCLUSIONS: COVID-19 has drastically disrupted several functional, cognitive and biological variables. These results may be useful in identifying clinical parameters that deserve closer attention in the case of a new health crisis. Further studies are needed to assess the potential impacts of each specific chronic condition. IMPACT: Cognitive and functional status, blood pressure and triglycerides and LDL levels worsen in short term, maintaining the negative effects in medium-term.

Assessing the Risk of Hypertension in Chronic, Elderly Patients during the COVID-19 Pandemic: A Prospective Study.

BACKGROUND: This study considers care management for older chronic patients during and after the COVID-19 pandemic. AIMS: To identify groups of variables at previous time points as a basis for deriving efficient classification models during and after a pandemic situation and to quantify the effect of each variable within the model to predict levels of worsening risk in diastolic and systolic arterial hypertension (AHT). MATERIAL AND METHODS: In this prospective longitudinal study, data were collected at three time points: before, during, and after the COVID-19 pandemic period. RESULTS: The study included 148 patients with an average age of 81.6 years. During the study period, mean systolic blood pressure among this population rose by 5 mmHg to 128.8 mmHg; the number of patients with systolic blood pressure > 140 mmHg rose by 45.3%; among those with diastolic blood pressure > 90, the number rose by 41.2%; mean triglycerides levels rose to 152.6 mg/dL; cholesterol levels rose to 147 mg/dL; and LDL cholesterol rose to 112.2 mg/dL. Meanwhile, mean levels of HDL cholesterol decreased to 46.5 mg/dL. Binary-response logistic regression models were constructed to identify the most relevant variables for predicting AHT risk during and after the pandemic. The heart rate (OR = 1.79; 95% CI: 1.22-2.72) and body mass index (OR = 1.75; 95% CI: 1.08-2.94) variables were significant at the population level (p < 0.05) for diastolic and systolic AHT in the pandemic period risk models. The body mass index variable was also significant for diastolic AHT in the post-pandemic period risk model (OR = 1.97; 95% CI: 1.32-2.94), whilst the triglycerides variable was significant in the systolic AHT post-pandemic period risk model (OR = 1.49; 95% CI: 1.01-1.86). CONCLUSIONS: Bad control of arterial hypertension in older patients with chronic disease is associated with elevated levels of LDL cholesterol, total cholesterol, systolic blood pressure, heart rate and triglycerides, and lower levels of HDL cholesterol.