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During the COVID-19 pandemic, there were reports of heightened levels of anxiety and fear of contagion in the general population. Such psychological responses may be influenced by the socio-environmental context in which individuals reside. This study aimed to examine the relationship between socioeconomic and educational factors and the level of anxiety and fear related to COVID-19. A multicenter, cross-sectional design was used, including patients aged 18 years or older who attended primary care physician consultations at various primary health centers in Toledo, Spain, between October 2020 and January 2021. By means of a non-probabilistic sampling, a total of 150 participants were selected for the study, with 146 of them providing responses to the AMICO questionnaire The level of fear and anxiety associated with COVID-19 was assessed using the validated Anxiety and Fear of COVID-19 Assessment Scale (AMICO). A significant linear relationship was revealed between social class, employment status, and anxiety levels. Specifically, as social class decreased (p = 0.001) and employment situation worsened (unemployment) (p = 0.037), the proportion of participants reporting a high level of anxiety increased. During the second phase of the pandemic, more than half of the patients attending family medicine consultations exhibited a high level of fear and anxiety towards COVID-19, which was significantly associated with lower social class and unemployment.
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BACKGROUND: Mother-to-child transmission (MTCT) during pregnancy, delivery or breastfeeding, is the main route of HIV infection in children. Strategies aimed at promoting the health of HIV infected pregnant women and MTCT prevention have reduced transmission to below 2%. This paper presents the clinical and epidemiological features of a cohort from Madrid and compares foreign-born with Spanish-born women. METHOD: Retrospective, observational and descriptive study on HIV infected pregnant women from South Madrid (n=70) and their offspring (n=78) who were born during the study period from August 1992 to January 2010. RESULTS: Most pregnant women were infected by heterosexual transmission (51%). Most Spanish-born women (66%) were diagnosed before pregnancy (81%), while foreign-born women (34%) were diagnosed during pregnancy (70%). Foreign-born women had less obstetric check-ups (67%) than Spanish-born women (97%). The MTCT rate was 1.3% during the last ten years. CONCLUSIONS: Heterosexual transmission is the primary mode of acquisition of HIV infection both for Spanish-born and foreign-born pregnant women. However, the HIV infection was diagnosed earlier in Spanish-born women. There were no differences in the effectiveness of antiretroviral therapy as a preventive measure against MTCT when it is started at an early stage.
Assuntos
Infecções por HIV , Transmissão Vertical de Doenças Infecciosas , Complicações Infecciosas na Gravidez , Adolescente , Adulto , Estudos de Coortes , Emigrantes e Imigrantes , Feminino , Infecções por HIV/epidemiologia , Infecções por HIV/transmissão , Humanos , Gravidez , Complicações Infecciosas na Gravidez/epidemiologia , Estudos Retrospectivos , Espanha/epidemiologia , Adulto JovemRESUMO
Objective: Isolation of suspected cases of COVID-19 has been shown effective in reducing disease transmission and monitoring these patients from primary care allows to detect complications. The objective of this study is to determine the evolution of a cohort of patients with suspected COVID-19, and to analyse the factors associated with hospital admissions due to their unfavourable evolution. Methods: Prospective cohort study. A cohort of 166 patients with COVID-19 symptoms was selected and was followed-up by telephone calls during 14 days of home isolation. Results: By the end of the follow-up, a hospital admission had taken place in 14.7% of patients. The mean survival time until admission among diabetics was 12.6, 10.9 days for chronic kidney diseases, and 9.3 days in immunocompromised patients. Immunosuppression was a risk factor for admission over 50 years of age. Conclusion: Hospital admissions for suspected cases of COVID-19 are associated with diabetes, chronic kidney disease, and immunosuppression. Telephone monitoring of these patients from primary care allows for home isolation and early detection of disease complications.
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COVID-19 , Isolamento de Pacientes , COVID-19/diagnóstico , COVID-19/epidemiologia , Estudos de Coortes , Humanos , Pessoa de Meia-Idade , Atenção Primária à Saúde , Estudos Prospectivos , TelefoneRESUMO
Diagnosis and home follow-up of patients affected by COVID-19 is being approached by primary health care professionals through telephone consultations. This modality of teleconsultation allows one to follow the evolution of patients and attend early to possible complications of the disease. The purpose of the study was to analyze the evolution of a cohort of patients with suspected SARS-CoV-2 disease followed by primary care professionals and to determine the factors that are associated with hospital admission. A prospective cohort study was carried out on 166 patients selected by consecutive sampling that showed symptoms compatible with COVID-19. The follow-up was approached via telephone for 14 days analyzing hospitalization and comorbidities of the patients. There were 75% of the hospitalized patients that were male (p = 0.002), and 70.8% presented comorbidities (p < 0.001). In patients with diabetes, the risk of hospitalization was 4.6-times larger, in hypertension patients it was 3.3-times, those suffering from renal insufficiency 3.8-times, and immunosuppressed patients 4.8-times (IC 95%: 1.9-11.7). In 86.7% of the cases, clinical deterioration was diagnosed in the first seven days of the infection, and 72% of healing was reached from day seven to fourteen. Monitoring from primary care of patients with COVID-19 allows early diagnosis of clinical deterioration and detection of comorbidities associated with the risk of poor evolution and hospital admission.
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Introducción La principal vía de adquisición del virus de la inmunodeficiencia humana (VIH) en la infancia es la transmisión vertical (TV), transmisión de madre a hijo durante el embarazo, el parto o la lactancia. Las estrategias encaminadas a la promoción de la salud y a la prevención en las mujeres VIH embarazadas han reducido la tasa de transmisión a menos del 2%. En este trabajo se presentan las características clínico-epidemiológicas de una cohorte materna de la zona sur de Madrid y se comparan los subgrupos de inmigrantes y españolas. Método Se trata de un estudio retrospectivo, observacional y descriptivo de la cohorte de gestantes con infección por VIH (n=70) y sus hijos (n=78) durante el periodo de estudio de agosto de 1992 hasta enero de 2010 en la zona sur de Madrid. Resultados La mayoría de las gestantes se infectaron por vía heterosexual (51%). Las pacientes españolas (66%) fueron diagnosticadas mayoritariamente antes del embarazo (81%), mientras que las inmigrantes (34%) lo fueron durante la gestación (70%). El control obstétrico fue menor en las gestantes inmigrantes (67%) que en las españolas (97%). La tasa de TV en los últimos 10 años fue del 1,3%.ConclusionesLa transmisión heterosexual fue la principal vía de adquisición de la infección por VIH en gestantes tanto españolas como inmigrantes. Sin embargo, el momento de diagnóstico fue más precoz en las españolas. No hay diferencias en la eficacia del tratamiento antirretroviral como prevención de la transmisión vertical cuando se inicia precozmente (AU)
Background Mother-to-child transmission (MTCT) during pregnancy, delivery or breastfeeding, is the main route of HIV infection in children. Strategies aimed at promoting the health of HIV infected pregnant women and MTCT prevention have reduced transmission to below 2%. This paper presents the clinical and epidemiological features of a cohort from Madrid and compares foreign-born with Spanish-born women. Method Retrospective, observational and descriptive study on HIV infected pregnant women from South Madrid (n=70) and their offspring (n=78) who were born during the study period from August 1992 to January 2010.ResultsMost pregnant women were infected by heterosexual transmission (51%). Most Spanish-born women (66%) were diagnosed before pregnancy (81%), while foreign-born women (34%) were diagnosed during pregnancy (70%). Foreign-born women had less obstetric check-ups (67%) than Spanish-born women (97%). The MTCT rate was 1.3% during the last ten years. Conclusions Heterosexual transmission is the primary mode of acquisition of HIV infection both for Spanish-born and foreign-born pregnant women. However, the HIV infection was diagnosed earlier in Spanish-born women. There were no differences in the effectiveness of antiretroviral therapy as a preventive measure against MTCT when it is started at an early stage (AU)