Asthma and coronavirus disease 2019-related outcomes in hospitalized patients: A single-center experience.

BACKGROUND: Several chronic conditions have been associated with a higher risk of severe coronavirus disease 2019 (COVID-19), including asthma. However, there are conflicting conclusions regarding risk of severe disease in this population. OBJECTIVE: To understand the impact of asthma on COVID-19 outcomes in a cohort of hospitalized patients and whether there is any association between asthma severity and worse outcomes. METHODS: We identified hospitalized patients with COVID-19 with confirmatory polymerase chain reaction testing with (n = 183) and without asthma (n = 1319) using International Classification of Diseases, Tenth Revision, codes between March 1 and December 30, 2020. We determined asthma maintenance medications, pulmonary function tests, highest historical absolute eosinophil count, and immunoglobulin E. Primary outcomes included death, mechanical ventilation, intensive care unit (ICU) admission, and ICU and hospital length of stay. Analysis was adjusted for demographics, comorbidities, smoking status, and timing of illness in the pandemic. RESULTS: In unadjusted analyses, we found no difference in our primary outcomes between patients with asthma and patients without asthma. However, in adjusted analyses, patients with asthma were more likely to have mechanical ventilation (odds ratio, 1.58; 95% confidence interval [CI], 1.02-2.44; P = .04), ICU admission (odds ratio, 1.58; 95% CI, 1.09-2.29; P = .02), longer hospital length of stay (risk ratio, 1.30; 95% CI, 1.09-1.55; P < .003), and higher mortality (hazard ratio, 1.53; 95% CI, 1.01-2.33; P = .04) compared with the non-asthma cohort. Inhaled corticosteroid use and eosinophilic phenotype were not associated with considerabledifferences. Interestingly, patients with moderate asthma had worse outcomes whereas patients with severe asthma did not. CONCLUSION: Asthma was associated with severe COVID-19 after controlling for other factors.

Evaluation of the National Case Report Form for dengue and timely case notification before the co-circulation of multiple arboviruses in Barranquilla, Colombia / Evaluación del formulario nacional de informe de caso para dengue y de la puntualidad en la notificación del caso antes de la co-circulación de múltiples arbovirus en Barranquilla-Colombia

ABSTRACT Objective To evaluate the case report forms and times elapsed between the surveillance steps for dengue virus (DENV) infection in a large Colombian city before the emergence of other arbovirus epidemics. Materials and Methods The descriptive epidemiology of DENV infection cases was analyzed from 2009 to 2013. The completeness of the case report forms filed at the Primary Units of Data Generation (PUDG) were evaluated, as well as the accuracy and suitability of the tests (PPV: positive predictive value). The average time-lags between each step were then calculated. Results There were 7.3, 12.38, 4.66, 6.25 and 29.9 annual cases of dengue infection per 10 000 inhabitants in 2009 to 2013, respectively. In this study, only 57.76% of the cases were classified correctly by the physicians and 26.32% of them were questioned about their home conditions and whether their family/friends had similar symptoms. Patients visited a clinic/hospital on average 4.76 days after developing symptoms and the health system was notified on average 1.75 days later, while 70.6% of them were reported within the one-day target period. There were only minor changes in case reporting times even during a DENV epidemic. Some (12.85%) of the case forms were later modified (average 16.7 days). In the period 2009-2013, the IgM confirmed PPV was 58.60%, while 20 mandatory criteria were absent on more than 25% of the forms. Conclusions The system was accurate, simple, flexible, stable and acceptable, but a number of ways are suggested to improve this case detection and reporting system.(AU)

RESUMEN Objetivo Evaluar los formularios de informe de casos y los tiempos entre los pasos de vigilancia para el dengue en una ciudad colombiana antes de la aparición de otras epidemias de arbovirus. Materiales y Métodos Se analizó la epidemiología descriptiva entre 2009 y 2013. Se evaluó la integridad de los formularios de informes de casos, registrados en las Unidades Primarias de Generación de Datos, así como el valor predictivo (VPP) de las pruebas diagnósticas. Se calcularon los intervalos de tiempo promedio entre cada paso de la vigilancia. Resultados Hubo 7.3, 12.38, 4.66, 6.25 y 29.9 casos anuales por cada 10 000 habitantes en 2009-2013, respectivamente. Solo el 57.76% de los casos fueron clasificados correctamente por los médicos, el 26.32% de ellos fueron interrogados sobre las condiciones de su hogar y si sus familiares/amigos tenían síntomas similares. Los pacientes se presentaron a una clínica/hospital en promedio 4.76 días después de desarrollar síntomas y el sistema de salud fue notificado en promedio 1.75 días más tarde, mientras que el 70.6% de ellos se informaron dentro del período objetivo de un día. Algunos (12.85%) de los formularios de casos se modificaron posteriormente (promedio de 16.7 días). Desde 2009-2013, el VPP confirmado por IgM fue de 58.60%, mientras que veinte criterios obligatorios estuvieron ausentes en más del 25% de los formularios. Conclusiones El sistema fue preciso, simple, flexible, estable y aceptable, pero sugerimos varias formas de mejorar este sistema de detección e informe de casos.(AU)

Evaluation of the National Case Report Form for dengue and timely case notification before the co-circulation of multiple arboviruses in Barranquilla, Colombia.

OBJECTIVE: To evaluate the case report forms and times elapsed between the surveillance steps for dengue virus (DENV) infection in a large Colombian city before the emergence of other arbovirus epidemics. MATERIALS AND METHODS: The descriptive epidemiology of DENV infection cases was analyzed from 2009 to 2013. The completeness of the case report forms filed at the Primary Units of Data Generation (PUDG) were evaluated, as well as the accuracy and suitability of the tests (PPV: positive predictive value). The average time-lags between each step were then calculated. RESULTS: There were 7.3, 12.38, 4.66, 6.25 and 29.9 annual cases of dengue infection per 10 000 inhabitants in 2009 to 2013, respectively. In this study, only 57.76% of the cases were classified correctly by the physicians and 26.32% of them were questioned about their home conditions and whether their family/friends had similar symptoms. Patients visited a clinic/hospital on average 4.76 days after developing symptoms and the health system was notified on average 1.75 days later, while 70.6% of them were reported within the one-day target period. There were only minor changes in case reporting times even during a DENV epidemic. Some (12.85%) of the case forms were later modified (average 16.7 days). In the period 2009-2013, the IgM confirmed PPV was 58.60%, while 20 mandatory criteria were absent on more than 25% of the forms. CONCLUSIONS: The system was accurate, simple, flexible, stable and acceptable, but a number of ways are suggested to improve this case detection and reporting system.