RESUMEN
The healthcare workforce has played an integral role in fighting COVID-19 and continues to do so despite the continuous adverse outcomes. To address this issue, official public data concerning COVID-19 cases and deaths of Peruvian physicians was used to quantify the risk of death and infection by SARS-CoV-2. 20.9% Peruvian physicians were infected and 0.7% died, with the male general practitioners being the most affected group within the workforce. Notably, the Loreto region was disproportionately affected and had the highest cumulative incidence, mortality and case fatality rate. Ultimately, this identified risk group needs to be supported with sufficient resources/tools such as personal protective equipment, training, access to health care, vaccination, etc.
Asunto(s)
COVID-19 , Médicos , COVID-19/epidemiología , Humanos , Masculino , Equipo de Protección Personal , Perú/epidemiología , SARS-CoV-2RESUMEN
BACKGROUND: Currently, there is no formally accepted pharmacological treatment for COVID-19. MATERIALS AND METHODS: We included COVID-19 outpatients of a Peruvian primary care center from Lima, Peru, who were treated between April 30 - September 30, 2020, with hydroxychloroquine and azithromycin. Logistic regression was applied to determine factors associated with case-fatality rate. RESULTS: A total of 1265 COVID-19 patients with an average age of 44.5 years were studied. Women represented 50.1% of patients, with an overall 5.9 symptom days, SpO2 97%, temperature of 37.3 °C, 41% with at least one comorbidity and 96.1% one symptom or sign. No patient treated within the first 72 h of illness died. The factors associated with higher case fatality rate were age (OR = 1.06; 95% CI 1.01-1.11, p = 0.021), SpO2 (OR = 0.87; 95% CI 0.79-0.96, p = 0.005) and treatment onset (OR = 1.16; 95% CI 1.06-1.27, p = 0.002), being the latter the only associated in the multivariate analysis (OR = 1.18; 95% CI 1.05-1.32, p = 0.005). 0.6% of our patients died. CONCLUSIONS: The case fatality rate in COVID-19 outpatients treated with hydroxychloroquine/azithromycin was associated with the number of days of illness on which treatment was started.
Asunto(s)
Tratamiento Farmacológico de COVID-19 , Hidroxicloroquina , Adulto , Azitromicina/uso terapéutico , Quimioterapia Combinada , Femenino , Humanos , Hidroxicloroquina/uso terapéutico , Saturación de Oxígeno , SARS-CoV-2 , Tiempo de TratamientoAsunto(s)
Síntomas Conductuales/epidemiología , COVID-19/epidemiología , Centros Comunitarios de Salud Mental/estadística & datos numéricos , Trastornos Mentales/epidemiología , Salud Mental/estadística & datos numéricos , Psiquiatría/estadística & datos numéricos , Salud Pública/estadística & datos numéricos , Adolescente , Adulto , COVID-19/economía , Niño , Centros Comunitarios de Salud Mental/economía , Humanos , Trastornos Mentales/economía , Salud Mental/economía , Perú/epidemiología , Psiquiatría/economía , Salud Pública/economíaRESUMEN
Resumen Objetivo: Describir los diferentes elementos psico-espirituales en pacientes con cáncer aplicando la escala Functional Assessment of Chronic Illness Therapy - Spiritual Well Being, FACIT-Sp (Evaluación Funcional de Terapia de Enfermedades Crónicas y Bienestar Espiritual). Métodos: Aplicación de la escala a una muestra de pacientes (n =100) con diagnóstico de cáncer, estadio IV, del Servicio de Oncología del Hospital Nacional Arzobispo Loayza. El instrumento de 33 preguntas examina cinco áreas: bienestar social (SWB), bienestar emocional (EWB), bienestar funcional (FWB), sentido y paz (MP) y fe (F). Resultados: En la muestra estudiada, el aspecto más resaltante fue el relacionado con F (puntaje promedio=13,53 ± 3,05, correspondiente al 84,56% del puntaje máximo posible) y el más bajo fue el vinculado a FWB (puntaje promedio=15,79 ± 6,89, correspondiente al 56,39% del puntaje máximo posible). Conclusiones: De acuerdo a FACIT-Sp, el aspecto psico-espiritual más desarrollado en los pacientes de la muestra estudiada fue el relativo a la Fe y el menos desarrollado, el vinculado al área de Bienestar Funcional.
Summary Objective: To describe different psycho-spiritual elements in a sample of stage IV cancer patients from a public hospital in Lima, Peru, through the application of the Functional Assessment of Chronic Illness Therapy - Spiritual Well-Being (FACIT-Sp) scale. Methods: Application of FACIT-Sp to a sample of patients (n = 100) diagnosed with stage IV cancer at the Oncology Service of the Hospital Nacional Arzobispo Loayza. The 33-question instrument, designed to evaluate psycho-spiritual elements, analyzes five areas: social well-being (SWB), emotional well-being (EWB), functional well-being (FWB), meaning and peace (MP) and faith (F). Results: The most prominent aspect was F (average score=13.53 ± 3.05, corresponding to 84.56% of the maximum possible score), and the lowest was FWB (average score=15.79 ± 6.89, corresponding to 56.39% of the maximum possible score). Conclusions: According to FACIT-Sp, the most developed psycho-spiritual aspect among the participating patients was the one related to Faith, whereas the least developed, the one linked to the area of Functional Well-Being.