[Severe SARS-CoV-2 infection: Clinical assessment and biomechanical functional evaluation one month after hospital discharge]. / Infección grave por SARS-CoV-2: valoración clínica y evaluación funcional biomecánica al mes del alta hospitalaria.

OBJECTIVE: To describe by an observational cross-sectional study the clinical and functional situation, at one month after hospital discharge, of patients admitted with COVID-19 in the hospital ICU between March and December 2020. MATERIAL AND METHODS: 59 patients were studied using different clinical scales and biomechanical analysis tests (hand dynamometry, fall risk assessment, gait and balance analysis). RESULTS: At one month after discharge, patients reported persistent symptoms: dyspnea (47.5%), arthromyalgia (45%) and cough (22%). In the EQ-5D-5L questionnaire up to 73% of patients reported levels of anxiety or depression. 74.6% and 69.5% presented alterations in the strength of the right and left hand, respectively. The risk of falls in 38% of patients was moderate to very high. The somatosensory index remained within normal parameters, while the vestibular and, to a lesser extent, the visual indexes were altered. In gait, 81.4% of patients showed no abnormalities outside the normal range, with a normal average walking speed. CONCLUSIONS: In the short term after severe COVID-19, patients have persistent symptomatology, anxiety/depression, impaired balance with increased risk of falls and loss of grip strength in both hands.

Impact of self-financed rotavirus vaccines on hospital stays and costs in Spain after a 3-year introductory period.

Vaccination has reduced rotavirus hospitalizations by 25% in European regions with low-moderate vaccine availability. We aimed to quantify the reduction in hospital costs after the longest period in which Rotarix® and Rotateq® were simultaneously commercially available in Spain. Cases, length of stay (LOS), and diagnosis-related groups (DRGs) were retrieved from the Minimum Basic Data Set. Healthcare expenditure was estimated through the cost accounting system Gescot®. DRGs were clustered: I, non-bacterial gastroenteritis with complications; II, without complications; III, requiring surgical/other procedures or neonatal cases (highest DRG weights). Comparisons between pre (2003-2005)- and post-vaccine (2007-2009) hospital stays and costs by DRG group were made. Rotaviruses were the most common agents of specific-coded gastroenteritis (N = 1657/5012). LOS and extended LOS of rotaviruses fell significantly in 2007-2009 (ß-coefficient = -0·43, 95% confidence intervals (95% CI) -0·68 to -0·17; and odds ratio 0·62, 95% CI 0·50-0·76, respectively). Overall, costs attributable to rotavirus hospitalizations fell approximately €244 per patient (95% CI -365 to -123); the decrease in DRG group III was €2269 per patient (95% CI -4098 to -380). We concluded modest savings in hospital costs, largely attributable to cases with higher DRG weights, and a faster recovery. A universal rotavirus vaccination program deserves being re-evaluated, regarding its potential high impact on both at-risk children and societal costs.

[Evaluation of microalbuminuria in children]. / Valoración de microalbuminuria en una población pediátrica.

Microalbuminuria has been shown to be important for the diagnosis and prognosis of glomerular nephropathy. A few studies in normal healthy children were performed. The concentration of albumin was determined in 171 samples of the first morning urine by an immunoturbidimetric method. Microalbumin/creatinine ratio values were 4.07 +/- 0.11 mg/mmol, 1.16 +/- 0.10 mg/mmol and 0.88 +/- 0.11 mg/mmol in children of ages 4 days-1 year, 1-7 years and 7-15 years, respectively. We found a negative inverse correlation (r = 0.31; p < 0.05) between age and microalbumin/creatinine ratio.