Antiplatelet therapy and outcome in COVID-19: the Health Outcome Predictive Evaluation Registry.

BACKGROUND: Standard therapy for COVID-19 is continuously evolving. Autopsy studies showed high prevalence of platelet-fibrin-rich microthrombi in several organs. The aim of the study was therefore to evaluate the safety and efficacy of antiplatelet therapy (APT) in hospitalised patients with COVID-19 and its impact on survival. METHODS: 7824 consecutive patients with COVID-19 were enrolled in a multicentre international prospective registry (Health Outcome Predictive Evaluation-COVID-19 Registry). Clinical data and in-hospital complications were recorded. Data on APT, including aspirin and other antiplatelet drugs, were obtained for each patient. RESULTS: During hospitalisation, 730 (9%) patients received single APT (93%, n=680) or dual APT (7%, n=50). Patients treated with APT were older (74±12 years vs 63±17 years, p<0.01), more frequently male (68% vs 57%, p<0.01) and had higher prevalence of diabetes (39% vs 16%, p<0.01). Patients treated with APT showed no differences in terms of in-hospital mortality (18% vs 19%, p=0.64), need for invasive ventilation (8.7% vs 8.5%, p=0.88), embolic events (2.9% vs 2.5% p=0.34) and bleeding (2.1% vs 2.4%, p=0.43), but had shorter duration of mechanical ventilation (8±5 days vs 11±7 days, p=0.01); however, when comparing patients with APT versus no APT and no anticoagulation therapy, APT was associated with lower mortality rates (log-rank p<0.01, relative risk 0.79, 95% CI 0.70 to 0.94). On multivariable analysis, in-hospital APT was associated with lower mortality risk (relative risk 0.39, 95% CI 0.32 to 0.48, p<0.01). CONCLUSIONS: APT during hospitalisation for COVID-19 could be associated with lower mortality risk and shorter duration of mechanical ventilation, without increased risk of bleeding. TRIAL REGISTRATION NUMBER: NCT04334291.

[Preparation of a questionnaire to detect cases of hate violence in emergency rooms]. / Elaboración de un cuestionario de detección de casos de violencia de odio en urgencias hospitalarias.

OBJECTIVE: In the context of the SIVIVO project, the development of a tool to facilitate the detection, recording and description of cases of hate violence and its consequences on health was proposed. METHOD: A two-round Delphi method was used with experts from clinical-care, public health, epidemiological, academic, administration and non-governmental organizations to assess the relevance of different items using a Likert scale, presenting the results with medians and coefficients of variation. RESULTS: The best evaluated questions, with scores equal to or greater than 4, and which make up the final version of the questionnaire are the relative socio-demographic characteristics of the victim, the injuries, description of the incident, the motivations perceived by the aggrieved person, possible evidence of hatred, the intention to denounce and the perception of the health personnel of the motive for the aggression. The piloting showed the adequacy of the questions that were finally selected. CONCLUSIONS: The systematic incorporation of this tool can help us to learn the magnitude and characteristics of hate violence and its impact on health. This information would allow the elaboration of prevention and intervention strategies aimed, specifically, at the sectors of the population most exposed to this type of violence.