Factores asociados a la anosmia y ageusia en pacientes COVID-19 de una provincia peruana / Factors associated with anosmia and ageusia in COVID-19 patients in a Peruvian province

Objetivo: identificar la presentación clínica y los factores asociados a la anosmia y ageusia en pacientes con la COVID-19 en un centro de salud de una provincia del Perú en el período de 2020-2021. Métodos: estudio transversal analítico a través de los datos del programa COVID-19 del Policlínico Essalud de Jauja - Perú. Se detallaron características sociodemográficas, sintomatología y comorbilidades de los pacientes. A través de un análisis bivariado se identificó los factores asociados a la anosmia y ageusia. Resultados: se identificó a 356 pacientes: 53,1 % fueron mujeres, la edad media fue 48,7 años (±17,8) y 261 (73,3 %) con COVID-19 leve. Del total, el 22,2 % presentó anosmia y 19,9 % ageusia; de los cuales la mayoría fueron menores de 65 años y del sexo femenino. Presentaron síntomas asociados un 86,1 % de los pacientes con anosmia y un 83,1% con ageusia. Los principales factores asociados a la anosmia fueron: la edad menor a 65 años (p=0,027), tos (p<0,001), cefalea (p<0,001), disnea (p<0,001), congestión nasal (p<0,001) y fiebre (p<0,001); y a la ageusia: edad menor a 65 años (p=0,006), tos (p=0,001), cefalea (p<0,001), disnea (p<0,001), congestión nasal (p<0,001) y diarrea (p<0,001). Conclusiones: la anosmia y ageusia son síntomas frecuentes de la COVID-19. La mayoría de pacientes presentaron estos síntomas asociados a los síntomas comunes. Gran parte de los que presentaban anosmia presentaron congestión nasal por lo que es recomendable considerar diferenciarlos al momento de realizar el diagnóstico.

Summary Objective: To identify the clinical presentation and factors associated with anosmia and ageusia in patients with COVID-19 in a health center in a province of Peru for the period 2020-2021. Methods: Cross-sectional analytical study through data from the COVID-19 program of the Essalud Polyclinic in Jauja, Peru. Sociodemographic characteristics, symptoms and comorbidities of the patients were detailed. A bivariate analysis identified the factors associated with anosmia and ageusia. Results: 356 patients were identified: 53.1 % were women, mean age was 48.7 years (±17.8) and 261 (73.3%) with mild COVID-19. Of the total, 22.2% had anosmia and 19.9% ageusia; of which the majority were under 65 and female. Associated symptoms were found in 86.1% of patients with anosmia and 83.1% with ageusia. The main factors associated with anosmia were age younger than 65 years (p=0.027), cough (p<0.001), headache (p<0.001), dyspnea (p<0.001), nasal congestion (p<0.001) and fever (p<0.001); and ageusia: age younger than 65 years (p=0.006), cough (p=0.001), headache (p<0.001), dyspnea (p<0.001), nasal congestion (p<0.001) and diarrhea (p<0.001). Conclusion: Anosmia and ageusia are common symptoms of COVID-19. Most patients had these symptoms associated with common symptoms. Many of those who had anosmia had nasal congestion, so it is advisable to consider differentiating them when making the diagnosis.

Evaluating the Levels of Awareness of and Attitudes on Advance Directives Among Primary Care Physicians in Puerto Rico.

OBJECTIVE: Advance directives (ADs) are legal documents designed to guarantee a patient's preference of care for the future. Primary care physicians (PCPs) have long been identified as key to promoting AD completion among patients. Furthermore, PCPs' levels of awareness of and attitudes toward ADs have been related to positive completion rates in patients. In this project, we sought to identify the levels of awareness and attitudes towards ADs in Puerto Rican PCPs. METHODS: Self-administered questionnaires were distributed at primary care medical conferences in Puerto Rico (PR) to explore the levels of awareness and attitudes of PCPs on ADs. RESULTS: A total of 332 surveys were collected. Overall, PCPs in PR had high selfrated knowledge of ADs, with the highest being reported among internal medicine physicians (8.63 ± 1.51). However, this self-rating was in stark contrast with the lower than 60% level of awareness of and commitment to reading the applicable laws on ADs in PR across all specialties. Puerto Rican PCPs showed strongly positive attitudes towards ADs and recognized them as useful tools for patients, healthcare workers, and families, enabling them to make healthcare decisions. Internal medicine practitioners showed the strongest positive attitudes of all PCPs. Despite the perceived usefulness of ADs, Puerto Rican PCPs had a low predisposition to complete their own ADs in the short term. CONCLUSION: Our results suggest that improvements in the education of health professionals with regard to ADs are needed to increase in physicians both their knowledge of the legal standards governing ADs and their commitment to ensuring that patients complete such directives.