ABSTRACT
The objectives of this study are to develop a predictive model of hospital admission for COVID-19 to help in the activation of emergency services, early referrals from primary care, and the improvement of clinical decision-making in emergency room services. The method is the retrospective cohort study of 49,750 patients with microbiological confirmation of SARS-CoV-2 infection. The sample was randomly divided into two subsamples, for the purposes of derivation and validation of the prediction rule (60% and 40%, respectively). Data collected for this study included sociodemographic data, baseline comorbidities, baseline treatments, and other background data. Multilevel analyses with generalized estimated equations were used to develop the predictive model. Male sex and the gradual effect of age were the main risk factors for hospital admission. Regarding baseline comorbidities, coagulopathies, cancer, cardiovascular diseases, diabetes with organ damage, and liver disease were among the five most notable. Flu vaccination was a risk factor for hospital admission. Drugs that increased risk were chronic systemic steroids, immunosuppressants, angiotensin-converting enzyme inhibitors, and NSAIDs. The AUC of the risk score was 0.821 and 0.828 in the derivation and validation samples, respectively. Based on the risk score, five risk groups were derived with hospital admission ranging from 2.94 to 51.87%. In conclusion, we propose a classification system for people with COVID-19 with a higher risk of hospitalization, and indirectly with it a greater severity of the disease, easy to be completed both in primary care, as well as in emergency services and in hospital emergency room to help in clinical decision-making.Registration: ClinicalTrials.gov Identifier: NCT04463706.
Subject(s)
COVID-19 , SARS-CoV-2 , COVID-19/epidemiology , Hospitalization , Hospitals , Humans , Male , Primary Health Care , Retrospective StudiesABSTRACT
Objetivo: Explorar las experiencias y las vivencias de escolares de 7-8 años en una situación excepcional de alerta sanitaria en la que se han aplicado a la población estrictas medidas de confinamiento. Método: Estudio cualitativo exploratorio a través del análisis de ilustraciones realizadas por 71 escolares de 7-8 años de edad. El análisis se llevó a cabo según el marco teórico de Rose. Se realizó análisis descriptivo de los datos sociodemográficos. Resultados: Del análisis del contenido emergieron cinco categorías: 1) sentimientos de tristeza y miedo; 2) importancia del núcleo familiar, seguridad y protección; 3) hábitos de vida sedentarios durante el confinamiento; 4) infraestructuras de las viviendas y desigualdades sociales (la vida tras una ventana); y 5) respuesta social, lucha colectiva y de los/las profesionales de la salud. Conclusiones: La situación de pandemia de COVID-19 y las medidas estrictas de confinamiento han tenido un importante impacto en la población escolar, que es la que ha vivido las mayores restricciones. La infraestructura del hogar se ha mostrado como un claro diferenciador que ahonda en las desigualdades sociales y el impacto que la situación tiene en los/las escolares. Es necesario ampliar los estudios acerca del impacto psicosocial que esta situación va a tener a largo plazo en su salud física y mental. (AU)
Objective: To explore the experiences of schoolchildren in an exceptional health alert situation in which strict confinement measures have been applied to the population. Method: Qualitative exploratory study through the analysis of illustrations carried out by schoolchildren aged 7 to 8. The analysis was carried out according to Rose's theoretical framework. Descriptive analysis of socio-demographic data was performed. Results: Five categories emerged from the analysis of the content: 1) feelings of sadness and fear; 2) importance of the family nucleus, safety and protection; 3) sedentary living habits during confinement; 4) housing infrastructure and social inequalities (life through a window); and 5) social response, collective struggle and through health professionals. Conclusions: The COVID-19 pandemic situation and the strict confinement measures have had a significant impact on the school population, who had experienced the greatest restrictions. Household infrastructure has been shown to be a clear differentiator that deepens social inequalities and the impact that the situation has on school children. More studies are needed on the long-term psychosocial impact of this situation on their physical and mental health.
Subject(s)
Humans , Male , Female , Child , Pandemics , Coronavirus Infections/epidemiology , Child Health , Socioeconomic Factors , Education, Primary and Secondary , Qualitative ResearchABSTRACT
OBJECTIVE: To explore the experiences of schoolchildren in an exceptional health alert situation in which strict confinement measures have been applied to the population. METHOD: Qualitative exploratory study through the analysis of illustrations carried out by schoolchildren aged 7 to 8. The analysis was carried out according to Rose's theoretical framework. Descriptive analysis of socio-demographic data was performed. RESULTS: Five categories emerged from the analysis of the content: 1) feelings of sadness and fear; 2) importance of the family nucleus, safety and protection; 3) sedentary living habits during confinement; 4) housing infrastructure and social inequalities (life through a window); and 5) social response, collective struggle and through health professionals. CONCLUSIONS: The COVID-19 pandemic situation and the strict confinement measures have had a significant impact on the school population, who had experienced the greatest restrictions. Household infrastructure has been shown to be a clear differentiator that deepens social inequalities and the impact that the situation has on school children. More studies are needed on the long-term psychosocial impact of this situation on their physical and mental health.
