Open data for monitoring COVID-19 in Spain: Descriptive study.

BACKGROUND: The indicators of the pandemic have been based on the total number of diagnosed cases of COVID-19, the number of people hospitalized or in intensive care units, and deaths from the infection. The aim of this study is to describe the available data on diagnostic tests, health service used for the diagnosis of COVID-19, case detection and monitoring. METHOD: Descriptive study with review of official data available on the websites of the Spanish health councils corresponding to 17 Autonomous Communities, 2 Autonomous cities and the Ministry of Health. The variables collected refer to contact tracing, technics for diagnosis, use of health services and follow-up. RESULTS: All regions of Spain show data on diagnosed cases of COVID-19 and deaths. Hospitalized cases and intensive care admissions are shown in all regions except the Balearic Islands. Diagnostic tests for COVID-19 have been registered in all regions except Madrid region and Extremadura, with scarcely information on what type of test has been performed (present in 7 CCAA), requesting service and study of contacts. CONCLUSIONS: The information available on the official websites of the Health Departments of the different regions of Spain are heterogeneous. Data from the use of health service or workload in Primary Care, Emergency department or Out of hours services are almost non-existent.

Clinical pathway of COVID-19 patients in primary health care in 30 European countries: Eurodata study.

BACKGROUND: Most COVID-19 patients were treated in primary health care (PHC) in Europe. OBJECTIVES: To demonstrate the scope of PHC workflow during the COVID-19 pandemic emphasising similarities and differences of patient's clinical pathways in Europe. METHODS: Descriptive, cross-sectional study with data acquired through a semi-structured questionnaire in PHC in 30 European countries, created ad hoc and agreed upon among all researchers who participated in the study. GPs from each country answered the approved questionnaire. Main variable: PHC COVID-19 acute clinical pathway. All variables were collected from each country as of September 2020. RESULTS: COVID-19 clinics in PHC facilities were organised in 8/30. Case detection and testing were performed in PHC in 27/30 countries. RT-PCR and lateral flow tests were performed in PHC in 23/30, free of charge with a medical prescription. Contact tracing was performed mainly by public health authorities. Mandatory isolation ranged from 5 to 14 days. Sick leave certification was given exclusively by GPs in 21/30 countries. Patient hotels or other resources to isolate patients were available in 12/30. Follow-up to monitor the symptoms and/or new complementary tests was made mainly by phone call (27/30). Chest X-ray and phlebotomy were performed in PHC in 18/30 and 23/30 countries, respectively. Oxygen and low-molecular-weight heparin were available in PHC (21/30). CONCLUSION: In Europe PHC participated in many steps to diagnose, treat and monitor COVID-19 patients. Differences among countries might be addressed at European level for the management of future pandemics.

[Open data for monitoring COVID-19 in Spain: descriptive study]. / Datos abiertos de monitorización de la COVID-19 en España: estudio descriptivo.

BACKGROUND: The indicators of the pandemic have been based on the total number of diagnosed cases of COVID-19, the number of people hospitalized or in intensive care units, and deaths from the infection. The aim of this study is to describe the available data on diagnostic tests, health service used for the diagnosis of COVID-19, case detection and monitoring. METHOD: Descriptive study with review of official data available on the websites of the Spanish health councils corresponding to 17 Autonomous Communities, 2 Autonomous cities and the Ministry of Health. The variables collected refer to contact tracing, technics for diagnosis, use of health services and follow-up. RESULTS: all regions of Spain show data on diagnosed cases of COVID-19 and deaths. Hospitalized cases and intensive care admissions are shown in all regions except the Balearic Islands. Diagnostic tests for COVID-19 have been registered in all regions except Madrid region and Extremadura, with scarcely information on what type of test has been performed (present in 7 CCAA), requesting service and study of contacts. CONCLUSIONS: The information available on the official websites of the Health Departments of the different regions of Spain are heterogeneous. Data from the use of health service or workload in Primary Care, Emergency department or Out of hours services are almost non-existent.

Datos abiertos de monitorización de la COVID-19 en España: estudio descriptivo Open data for monitoring COVID-19 in Spain: descriptive study

Objetivo: Los indicadores del estado de pandemia se han basado en el número total de casos diagnosticados de la COVID-19, el número de personas hospitalizadas o en unidades de cuidados intensivos y los fallecimientos por la infección. El objetivo de este estudio es describir los datos disponibles sobre pruebas diagnósticas, servicio sanitario utilizado para el diagnóstico de COVID-19 y seguimiento/detección de casos. Método: Estudio descriptivo con revisión de datos oficiales disponibles en las páginas web de las consejerías de sanidad de España correspondientes a 17 Comunidades Autónomas (CCAA), 2 ciudades Autónomas y el Ministerio de Sanidad. Las variables recogidas hacen referencia al estudio de contactos, diagnóstico de casos, uso de servicios sanitarios y seguimiento. Resultados: todas las regiones de España muestran datos de los casos diagnosticados de COVID-19 y fallecidos. Los casos hospitalizados e ingresos en cuidados intensivos se muestran en todas las regiones excepto Baleares. Las pruebas diagnósticas de COVID-19 se han registrado en todas las regiones excepto Comunidad de Madrid y Extremadura, habiendo poca información sobre qué tipo de prueba se ha realizado (presente en 7 CCAA), servicio peticionario y estudio de contactos. Conclusiones: La información disponible en las páginas web oficiales de las Consejerías de Sanidad de las diferentes regiones de España son heterogéneas. Los datos sobre el uso o carga laboral a nivel de Atención Primaria o Servicios de urgencias hospitalarios y extrahospitalarios son cuasi inexistentes.

[The role of primary care during COVID-19 pandemic: A European overview]. / El papel de la atención primaria en la pandemia COVID-19: Una mirada hacia Europa.

We describe the role of primary care (PC) in 12 European countries in relation to the COVID-19 pandemic. There is no official information at European level on the activity of PC. The findings were: All countries provided COVID-19 information through telephone lines and websites to their citizens. Contact tracing was mainly carried out by Public Health except for Ireland, Portugal and Spain. The epidemiological surveillance task has overlapped with the PC assistance. Active Infection Diagnostic Tests (AIDT) were performed in PC exclusively in Spain. The other countries performed them in external laboratories. Patients were followed-up in PC mostly by remote assessment. Health coverage for vulnerable populations and nursing homes has been regulated in all countries. There is a need for a strategic plan for PC in Europe that responds to the challenges posed.

SARS-CoV-2 pneumonia follow-up and long COVID in primary care: A retrospective observational study in Madrid city.

BACKGROUND: Patients with COVID-19 are follow-up in primary care and long COVID is scarcely defined. The study aim was to describe SARS-CoV-2 pneumonia and cut-offs for defining long COVID in primary care follow-up patients. METHODS: A retrospective observational study in primary care in Madrid, Spain, was conducted. Data was collected during 6 months (April to September) in 2020, during COVID-19 first wave, from patients ≥ 18 years with SARS-CoV-2 pneumonia diagnosed. Variables: sociodemographic, comorbidities, COVID-19 symptoms and complications, laboratory test and chest X-ray. Descriptive statistics were used, mean (standard deviation (SD)) and medians (interquartile range (IQR)) respectively. Differences were detected applying X2 test, Student's T-test, ANOVA, Wilcoxon-Mann-Whitney or Kruskal-Wallis depending on variable characteristics. RESULTS: 155 patients presented pneumonia in day 7.8 from the onset (79.4% were hospitalized, median length of 7.0 days (IQR: 3.0, 13.0)). After discharge, the follow-up lasted 54.0 median days (IQR 42.0, 88.0) and 12.2 mean (SD 6.4) phone calls were registered per patient. The main symptoms and their duration were: cough (41.9%, 12 days), dyspnoea (31.0%, 15 days), asthenia (26.5%, 21 days). Different cut-off points were applied for long COVID and week 4 was considered the best milestone (28.3% of the sample still had symptoms after week 4) versus week 12 (8.3%). Patients who still had symptoms >4 weeks follow-up took place over 81.0 days (IQR: 50.5, 103.0), their symptoms were more prevalent and lasted longer than those ≤ 4 weeks: cough (63.6% 30 days), dyspnoea (54.6%, 46 days), and asthenia (56.8%, 29 days). Embolism was more frequent in patients who still had symptoms >4 weeks than those with symptoms ≤4 weeks (9.1% vs 1.8%, p value 0.034). CONCLUSION: Most patients with SARS-CoV-2 pneumonia recovered during the first 4 weeks from the beginning of the infection. The cut-off point to define long COVID, as persisting symptoms, should be between 4 to 12 weeks from the onset of the symptoms.

Using mobile applications and websites for the diagnosis of COVID-19 in Spain.

INTRODUCTION: New tools are needed for early evaluation of patients who could be infected by COVID-19 during this pandemic. M-Health (apps) could be a solution in this setting to evaluate a COVID-19 diagnosis. The aim of this study was to describe which COVID-19s apps are available in Spain. METHODS: We made a review of the diagnosis apps and websites of the different regions of Spain. We described the different characteristics of each app. RESULTS: We analyzed 6 apps, 5 corresponding to Autonomous Communities and one from the Ministry of Health, as well as 4 website test from the respectively health region. There were detected multiples differences between the m-Health methods analysed from the information collected to the information shared to citizens. However, all m-Health methods asked about the classic triad symptoms: fever, cough and dyspnoea. CONCLUSION: Although the COVID-19 Spanish crisis have been lead from the Ministry of Health, it has been detected different methods to apply m-Health though the multiple Spanish regions.

[Human resource management and vaccination strategies in primary care in Europe during COVID-19 pandemic]. / Gestión de los recursos humanos y estrategias de vacunación en atención primaria en Europa en la pandemia COVID-19.

This article describes the management of human resource and the vaccination strategies in primary care in twelve European countries in relation to the COVID-19 pandemic. All the countries have found solutions to increase their workforce in primary care. Other healthcare professionals were incorporated to support family doctors assuming their tasks, under their supervision and coordination. The European Commission had a crucial role in the production, purchase and distribution of the vaccines. The engagement of primary care in the vaccination campaign has had an unequal participation in the different countries, although the greatest burden has been managed from the government's public health departments.

Using mobile applications and websites for the diagnosis of COVID-19 in Spain. / Uso de aplicaciones móviles y páginas web para el diagnóstico de la COVID-19 en España.

INTRODUCTION: New tools are needed for early evaluation of patients who could be infected by COVID-19 during this pandemic. M-Health (apps) could be a solution in this setting to evaluate a COVID-19 diagnosis. The aim of this study was to describe which COVID-19s apps are available in Spain. METHODS: We made a review of the diagnosis apps and websites of the different regions of Spain. We described the different characteristics of each app. RESULTS: We analyzed 6 apps, 5 corresponding to Autonomous Communities and one from the Ministry of Health, as well as 4 website test from the respectively health region. There were detected multiples differences between the m-Health methods analysed from the information collected to the information shared to citizens. However, all m-Health methods asked about the classic triad symptoms: fever, cough and dyspnoea. CONCLUSION: Although the COVID-19 Spanish crisis have been lead from the Ministry of Health, it has been detected different methods to apply m-Health though the multiple Spanish regions.