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1.
Ann Med ; 53(1): 103-116, 2021 12.
Artículo en Inglés | MEDLINE | ID: mdl-33063540

RESUMEN

BACKGROUND: Hyperglycaemia has emerged as an important risk factor for death in coronavirus disease 2019 (COVID-19). The aim of this study was to evaluate the association between blood glucose (BG) levels and in-hospital mortality in non-critically patients hospitalized with COVID-19. METHODS: This is a retrospective multi-centre study involving patients hospitalized in Spain. Patients were categorized into three groups according to admission BG levels: <140 mg/dL, 140-180 mg/dL and >180 mg/dL. The primary endpoint was all-cause in-hospital mortality. RESULTS: Of the 11,312 patients, only 2128 (18.9%) had diabetes and 2289 (20.4%) died during hospitalization. The in-hospital mortality rates were 15.7% (<140 mg/dL), 33.7% (140-180 mg) and 41.1% (>180 mg/dL), p<.001. The cumulative probability of mortality was significantly higher in patients with hyperglycaemia compared to patients with normoglycaemia (log rank, p<.001), independently of pre-existing diabetes. Hyperglycaemia (after adjusting for age, diabetes, hypertension and other confounding factors) was an independent risk factor of mortality (BG >180 mg/dL: HR 1.50; 95% confidence interval (CI): 1.31-1.73) (BG 140-180 mg/dL; HR 1.48; 95%CI: 1.29-1.70). Hyperglycaemia was also associated with requirement for mechanical ventilation, intensive care unit (ICU) admission and mortality. CONCLUSIONS: Admission hyperglycaemia is a strong predictor of all-cause mortality in non-critically hospitalized COVID-19 patients regardless of prior history of diabetes. KEY MESSAGE Admission hyperglycaemia is a stronger and independent risk factor for mortality in COVID-19. Screening for hyperglycaemia, in patients without diabetes, and early treatment of hyperglycaemia should be mandatory in the management of patients hospitalized with COVID-19. Admission hyperglycaemia should not be overlooked in all patients regardless prior history of diabetes.


Asunto(s)
Infecciones por Coronavirus/mortalidad , Hiperglucemia/complicaciones , Neumonía Viral/mortalidad , Sistema de Registros , Anciano , Anciano de 80 o más Años , Glucemia , Infecciones por Coronavirus/sangre , Infecciones por Coronavirus/complicaciones , Cuidados Críticos/estadística & datos numéricos , Femenino , Humanos , Hiperglucemia/mortalidad , Tiempo de Internación , Masculino , Persona de Mediana Edad , Pandemias , Neumonía Viral/sangre , Neumonía Viral/complicaciones , Respiración Artificial/estadística & datos numéricos , España/epidemiología
2.
Sci Total Environ ; 750: 142260, 2021 Jan 01.
Artículo en Inglés | MEDLINE | ID: mdl-33182217

RESUMEN

The ingestion of lead (Pb) ammunition is the most important exposure pathway to this metal in birds and involve negative consequences to their health. We have performed a passive monitoring of Pb poisoning in birds of prey by measuring liver (n = 727) and blood (n = 32) Pb levels in individuals of 16 species found dead or sick in Spain between 2004 and 2020. We also performed an active monitoring by measuring blood Pb levels and biomarkers of haem biosynthesis, phosphorus (P) and calcium (Ca) metabolism, oxidative stress and immune function in individuals (n = 194) of 9 species trapped alive in the field between 2016 and 2017. Passive monitoring results revealed some species with liver Pb levels associated with severe clinical poisoning (>30 µg/g d.w. of Pb): Eurasian griffon vulture (27/257, 10.5%), red kite (1/132, 0.8%), golden eagle (4/38, 10.5%), and Northern goshawk (1/8, 12.5%). The active monitoring results showed that individuals of bearded vulture (1/3, 33.3%), Eurasian griffon vulture (87/118, 73.7%), Spanish imperial eagle (1/6, 16.7%) and red kite (1/18, 5.6%) had abnormal blood Pb levels (>20 µg/dL). Blood Pb levels increased with age, and both monitoring methods showed seasonality in Pb exposure associated with a delayed effect of the hunting season. In Eurasian griffon, blood Pb concentration was associated with lower δ-ALAD activity in blood and P levels in plasma, and with higher blood lipid peroxidation and plasma carotenoid levels in agreement with other experimental and field studies in Pb-exposed birds. The study reveals that Pb poisoning is a significant cause of death and sublethal effects on haem biosynthesis, P metabolism and oxidative stress in birds of prey in Spain.


Asunto(s)
Águilas , Intoxicación por Plomo , Animales , Monitoreo del Ambiente , Humanos , Plomo/toxicidad , Intoxicación por Plomo/veterinaria , Estrés Oxidativo , España/epidemiología
3.
Sci Total Environ ; 750: 141424, 2021 Jan 01.
Artículo en Inglés | MEDLINE | ID: mdl-32853931

RESUMEN

The coronavirus disease 2019 (COVID-19) pandemic has caused an unprecedented global health crisis, with several countries imposing lockdowns to control the coronavirus spread. Important research efforts are focused on evaluating the association of environmental factors with the survival and spread of the virus and different works have been published, with contradictory results in some cases. Data with spatial and temporal information is a key factor to get reliable results and, although there are some data repositories for monitoring the disease both globally and locally, an application that integrates and aggregates data from meteorological and air quality variables with COVID-19 information has not been described so far to the best of our knowledge. Here, we present DatAC (Data Against COVID-19), a data fusion project with an interactive web frontend that integrates COVID-19 and environmental data in Spain. DatAC is provided with powerful data analysis and statistical capabilities that allow users to explore and analyze individual trends and associations among the provided data. Using the application, we have evaluated the impact of the Spanish lockdown on the air quality, observing that NO2, CO, PM2.5, PM10 and SO2 levels decreased drastically in the entire territory, while O3 levels increased. We observed similar trends in urban and rural areas, although the impact has been more important in the former. Moreover, the application allowed us to analyze correlations among climate factors, such as ambient temperature, and the incidence of COVID-19 in Spain. Our results indicate that temperature is not the driving factor and without effective control actions, outbreaks will appear and warm weather will not substantially limit the growth of the pandemic. DatAC is available at https://covid19.genyo.es.


Asunto(s)
Contaminantes Atmosféricos , Contaminación del Aire , Infecciones por Coronavirus , Coronavirus , Pandemias , Neumonía Viral , Contaminantes Atmosféricos/análisis , Contaminación del Aire/análisis , Betacoronavirus , Humanos , Material Particulado/análisis , España/epidemiología
4.
Brasília; IPEA; 20200500. 73 p. ilus.(Texto para Discussão / IPEA, 2559).
Monografía en Portugués | LILACS, ECOS | ID: biblio-1100677

RESUMEN

Este texto apresenta um panorama internacional das medidas econômicas adotadas para reduzir os graves efeitos econômicos da pandemia de Sars-COV-2 em três países: Estados Unidos, Reino Unido e Espanha. A análise toma como base primordialmente documentos governamentais que normatizaram as medidas de política econômica. São analisados os diversos canais por meio dos quais a crise sanitária afeta a economia. Por um lado, estão os fatores de oferta: oferta de trabalho, produtividade do trabalho e funcionamento das cadeias produtivas. Por outro lado, encontram-se os fatores de demanda: consumo das famílias, investimento privado e comércio exterior. O terceiro canal diz respeito aos fatores financeiros que incidem sobre as variáveis de demanda e, principalmente, sobre o grau de liquidez das empresas financeiras e não financeiras. As medidas adotadas nos três países apresentam como características comuns a mobilização de grande volume de recursos fiscais e financeiros, a adoção de uma grande diversidade de instrumentos de política econômica e o uso de arranjos institucionais sofisticados em termos de regras de focalização e de mecanismos de operacionalização das medidas adotadas.


This text presents an international overview of the economic measures adopted to reduce the serious economic effects of the Sars-COV-2 pandemic in three countries: the USA, the United Kingdom and Spain. The analysis is based primarily on government documents that regulated economic policy measures. The various channels through which the health crisis affects the economy are analyzed. On one hand, there are the supply factors: labor supply, labor productivity and the functioning of production chains. On the other hand, there are demand factors: household consumption, private investment and foreign trade. The third channel concerns the financial factors on demand variables and, mainly, on the degree of liquidity of financial and non-financial companies. The measures adopted in the three countries have as common characteristics the mobilization of large volumes of fiscal and financial resources, the adoption of a wide range of economic policy instruments and the use of sophisticated institutional arrangements in terms of targeting rules and mechanisms for operationalizing the measures adopted.


Asunto(s)
Política Pública , Coronavirus , Pandemias , España/epidemiología , Estados Unidos/epidemiología , Reino Unido/epidemiología
7.
PLoS One ; 15(11): e0241743, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33166344

RESUMEN

The Coronavirus Disease 2019 (COVID-19) has fast spread to over 200 countries and regions worldwide since its outbreak, while in March, Europe became the emerging epicentre. In this study, we aimed to model the epidemic trends and estimate the essential epidemic features of COVID-19 in Italy, Spain, Germany, and France at the initial stage. The numbers of daily confirmed cases and total confirmed cases were extracted from the Coronavirus disease (COVID-19) situation reports of WHO. We applied an extended Susceptible-Exposed-Infectious-Removed (SEIR) model to fit the epidemic trend and estimated corresponding epidemic features. The transmission rate estimates were 1.67 (95% credible interval (CrI), 1.64-1.71), 2.83 (2.72-2.85), 1.91 (1.84-1.98), and 1.89 (1.82-1.96) for Italy, Spain, Germany, and France, corresponding to the basic reproduction numbers (R0) 3.44 (3.35-3.54), 6.25 (5.97-6.55), 4.03 (3.84-4.23), and 4.00 (3.82-4.19), respectively. We found Spain had the lowest ascertainment rate of 0.22 (0.19-0.25), followed by France, Germany, and Italy of 0.45 (0.40-0.50), 0.46 (0.40-0.52), and 0.59 (0.55-0.64). The peaks of daily new confirmed cases would reach on April 16, April 5, April 21, and April 19 for Italy, Spain, Germany, and France if no action was taken by the authorities. Given the high transmissibility and high covertness of COVID-19, strict countermeasures, such as national lockdown and social distancing, were essential to be implemented to reduce the spread of the disease.


Asunto(s)
Infecciones por Coronavirus/diagnóstico , Modelos Teóricos , Neumonía Viral/diagnóstico , Betacoronavirus/aislamiento & purificación , Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/virología , Brotes de Enfermedades , Francia/epidemiología , Alemania/epidemiología , Humanos , Italia/epidemiología , Pandemias , Neumonía Viral/epidemiología , Neumonía Viral/virología , España/epidemiología
8.
Artículo en Inglés | MEDLINE | ID: mdl-33198392

RESUMEN

This paper analyzes a sample of patients hospitalized with COVID-19 in the region of Madrid (Spain). Survival analysis, logistic regression, and machine learning techniques (both supervised and unsupervised) are applied to carry out the analysis where the endpoint variable is the reason for hospital discharge (home or deceased). The different methods applied show the importance of variables such as age, O2 saturation at Emergency Rooms (ER), and whether the patient comes from a nursing home. In addition, biclustering is used to globally analyze the patient-drug dataset, extracting segments of patients. We highlight the validity of the classifiers developed to predict the mortality, reaching an appreciable accuracy. Finally, interpretable decision rules for estimating the risk of mortality of patients can be obtained from the decision tree, which can be crucial in the prioritization of medical care and resources.


Asunto(s)
Infecciones por Coronavirus/mortalidad , Aprendizaje Automático , Neumonía Viral/mortalidad , Betacoronavirus , Árboles de Decisión , Humanos , Pandemias , España/epidemiología
9.
PLoS One ; 15(11): e0241952, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33152009

RESUMEN

BACKGROUND: To provide an interpretable summary of the impact on mortality of the COVID-19 pandemic we estimate weekly and annual life expectancies at birth in Spain and its regions. METHODS: We used daily death count data from the Spanish Daily Mortality Monitoring System (MoMo), and death counts from 2018, and population on July 1st, 2019 by region (CCAA), age groups, and sex from the Spanish National Statistics Institute. We estimated weekly and annual (2019 and 2020*, the shifted annual calendar period up to 5 July 2020) life expectancies at birth as well as their differences with respect to 2019. RESULTS: Weekly life expectancies at birth in Spain were lower in weeks 11-20, 2020 compared to the same weeks in 2019. This drop in weekly life expectancy was especially strong in weeks 13 and 14 (March 23rd to April 5th), with national declines ranging between 6.1 and 7.6 years and maximum regional weekly declines of up to 15 years in Madrid. Annual life expectancy differences between 2019 and 2020 also reflected an overall drop in annual life expectancy of 0.9 years for both men and women. These drops ranged between 0 years in several regions (e.g. Canary and Balearic Islands) to 2.8 years among men in Madrid. CONCLUSIONS: Life expectancy is an easy to interpret measure for understanding the heterogeneity of mortality patterns across Spanish regions. Weekly and annual life expectancy are sensitive and useful indicators for understanding disparities and communicating the gravity of the situation because differences are expressed in intuitive year units.


Asunto(s)
Infecciones por Coronavirus/epidemiología , Esperanza de Vida , Neumonía Viral/epidemiología , Anciano , Betacoronavirus , Femenino , Humanos , Masculino , Persona de Mediana Edad , Pandemias , España/epidemiología
10.
Artículo en Inglés | MEDLINE | ID: mdl-33143172

RESUMEN

Nurses are exposed to psychosocial risks that can affect both psychological and physical health through stress. Prolonged stress at work can lead to burnout syndrome. An essential protective factor against psychosocial risks is emotional intelligence, which has been related to physical and psychological health, job satisfaction, increased job commitment, and burnout reduction. The present study aimed to analyze the effect of psychosocial risks and emotional intelligence on nurses' health, well-being, burnout level, and job satisfaction during the rise and main peak of the COVID-19 pandemic in Spain. It is a cross-sectional study conducted on a convenience sample of 125 Spanish nurses. Multiple hierarchical linear regression models were calculated considering emotional intelligence levels, psychosocial demand factors (interpersonal conflict, lack of organizational justice, role conflict, and workload), social support and emotional work on burnout, job satisfaction, and nurses' health. Finally, the moderating effect of emotional intelligence levels, psychosocial factors, social support, and emotional work on burnout, job satisfaction, and nurses' health was calculated. Overall, this research data points to a protective effect of emotional intelligence against the adverse effects of psychosocial risks such as burnout, psychosomatic complaints, and a favorable effect on job satisfaction.


Asunto(s)
Agotamiento Profesional/psicología , Agotamiento Psicológico/psicología , Infecciones por Coronavirus/psicología , Inteligencia Emocional/fisiología , Satisfacción en el Trabajo , Enfermeras y Enfermeros/psicología , Pandemias/prevención & control , Neumonía Viral/psicología , Adulto , Betacoronavirus , Agotamiento Profesional/epidemiología , Agotamiento Psicológico/epidemiología , Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/prevención & control , Estudios Transversales , Femenino , Humanos , Masculino , Persona de Mediana Edad , Cultura Organizacional , Neumonía Viral/epidemiología , Neumonía Viral/prevención & control , Justicia Social , Apoyo Social , España/epidemiología , Encuestas y Cuestionarios , Carga de Trabajo
14.
BMJ Open ; 10(11): e042398, 2020 11 10.
Artículo en Inglés | MEDLINE | ID: mdl-33172949

RESUMEN

OBJECTIVES: To describe demographic, clinical, radiological and laboratory characteristics, as well as outcomes, of patients admitted for COVID-19 in a secondary hospital. DESIGN AND SETTING: Retrospective case series of sequentially hospitalised patients with confirmed SARS-CoV-2, at Infanta Leonor University Hospital (ILUH) in Madrid, Spain. PARTICIPANTS: All patients attended at ILUH testing positive to reverse transcriptase-PCR on nasopharyngeal swabs and diagnosed with COVID-19 between 1 March 2020 and 28 May 2020. RESULTS: A total of 1549 COVID-19 cases were included (median age 69 years (IQR 55.0-81.0), 57.5% men). 78.2% had at least one underlying comorbidity, the most frequent was hypertension (55.8%). Most frequent symptoms at presentation were fever (75.3%), cough (65.7%) and dyspnoea (58.1%). 81 (5.8%) patients were admitted to the intensive care unit (ICU) (median age 62 years (IQR 51-71); 74.1% men; median length of stay 9 days (IQR 5-19)) 82.7% of them needed invasive ventilation support. 1393 patients had an outcome at the end of the study period (case fatality ratio: 21.2% (296/1393)). The independent factors associated with fatality (OR; 95% CI): age (1.07; 1.06 to 1.09), male sex (2.86; 1.85 to 4.50), neurological disease (1.93; 1.19 to 3.13), chronic kidney disease (2.83; 1.40 to 5.71) and neoplasia (4.29; 2.40 to 7.67). The percentage of hospital beds occupied with COVID-19 almost doubled (702/361), with the number of patients in ICU quadrupling its capacity (32/8). Median length of stay was 9 days (IQR 6-14). CONCLUSIONS: This study provides clinical characteristics, complications and outcomes of patients with COVID-19 admitted to a European secondary hospital. Fatal outcomes were similar to those reported by hospitals with a higher level of complexity.


Asunto(s)
Lesión Renal Aguda/fisiopatología , Infecciones por Coronavirus/fisiopatología , Neumonía Viral/fisiopatología , Síndrome de Dificultad Respiratoria del Adulto/fisiopatología , Lesión Renal Aguda/terapia , Corticoesteroides/uso terapéutico , Factores de Edad , Anciano , Anciano de 80 o más Años , Anticuerpos Monoclonales Humanizados/uso terapéutico , Antivirales/uso terapéutico , Betacoronavirus , Enfermedades Cardiovasculares/epidemiología , Comorbilidad , Infecciones por Coronavirus/complicaciones , Infecciones por Coronavirus/mortalidad , Infecciones por Coronavirus/terapia , Tos/fisiopatología , Disnea/fisiopatología , Femenino , Fiebre/fisiopatología , Hospitalización , Humanos , Hipertensión/epidemiología , Unidades de Cuidados Intensivos , Tiempo de Internación , Masculino , Persona de Mediana Edad , Neoplasias , Enfermedades del Sistema Nervioso/epidemiología , Pandemias , Neumonía Viral/complicaciones , Neumonía Viral/mortalidad , Neumonía Viral/terapia , Enfermedad Pulmonar Obstructiva Crónica/epidemiología , Insuficiencia Renal Crónica/epidemiología , Respiración Artificial , Síndrome de Dificultad Respiratoria del Adulto/terapia , Estudios Retrospectivos , Factores Sexuales , España/epidemiología
15.
Nutrients ; 12(11)2020 Nov 10.
Artículo en Inglés | MEDLINE | ID: mdl-33182816

RESUMEN

As a consequence of COVID-19, millions of households have suffered mobility restrictions and changes in their lifestyle over several months. The aim of this study is to evaluate the effects of COVID-19 home confinement on the food habits, lifestyle and emotional balance of the Spanish population. This cross-sectional study used data collected via an anonymous online questionnaire during the month before lockdown finished in Spain, with a total of 675 participants. 38.8% of the respondents experienced weight gain while 31.1% lost weight during confinement. The increase in body weight was positively correlated with age (Rs = 0.14, p < 0.05) and BMI (Rs = 0.20, p < 0.05). We also identified that 39.7% reported poorer quality sleep, positively correlated with BMI (Rs = -0.18, p < 0.05) and with age (Rs = -0.21, p < 0.05). 44.7% of the participants had not performed physical exercise during confinement with differences by sex (p < 0.05), by age (p < 0.05), by BMI (p < 0.05) and by sleep quality (p < 0.05). According to an emotional-eater questionnaire, 21.8% and 11% were classified as an emotional eater or a very emotional eater, respectively. We emphasize the importance of adopting a healthy lifestyle, as the COVID-19 pandemic is ongoing.


Asunto(s)
Infecciones por Coronavirus , Emociones , Ejercicio Físico , Conducta Alimentaria , Estilo de Vida , Pandemias , Neumonía Viral , Aislamiento Social , Adulto , Factores de Edad , Betacoronavirus , Índice de Masa Corporal , Peso Corporal , Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/psicología , Estudios Transversales , Dieta , Conducta Alimentaria/psicología , Femenino , Humanos , Masculino , Salud Mental , Persona de Mediana Edad , Neumonía Viral/epidemiología , Neumonía Viral/psicología , Conducta Sedentaria , Factores Sexuales , Sueño , Aislamiento Social/psicología , España/epidemiología , Encuestas y Cuestionarios
16.
Artículo en Inglés | MEDLINE | ID: mdl-33158180

RESUMEN

This study evaluates the psychological impact (PI) of the COVID-19 pandemic in frontline workers in Spain. Participants were 546 workers (296 healthcare workers, 105 media professionals, 89 grocery workers, and 83 protective service workers). They all completed online questionnaires assessing PI, sadness, concerns related to the COVID-19 pandemic, and demographic and work-related variables. All groups but protective services workers showed higher PI levels than the general population. Healthcare and grocery workers were the most affected, with 73.6% and 65.2% of the participants, respectively, showing a severe PI. Women showed a higher PI level. Healthcare workers in the regions with higher COVID-19 incidences reported greater PI levels. The main concerns were being infected by COVID-19 or infecting others. Levels of concern correlated with higher PI levels. The protection equipment was generally reported as insufficient, which correlated with higher PI levels. Professionals reporting to overwork during the crisis (60% mass-media, 38% of healthcare and grocery and 21.7% of protective service) showed higher PI levels. In the healthcare group, taking care of patients with COVID-19 (77%) or of dying patients with COVID-19 (43.9%) was associated with higher PI levels. The perceived social recognition of their work was inversely related to PI. Most of the sample had not received psychological support. We suggest some organizational measures for frontline institutions, such as the periodical monitoring or inclusion of psychologists specialized in crisis-management to prevent negative symptoms and provide timely support.


Asunto(s)
Infecciones por Coronavirus/psicología , Empleo/psicología , Personal de Salud/psicología , Ocupaciones , Neumonía Viral/psicología , Estrés Psicológico/epidemiología , Adulto , Betacoronavirus , Femenino , Humanos , Masculino , Persona de Mediana Edad , Pandemias , Sistemas de Apoyo Psicosocial , España/epidemiología
17.
Dis Aquat Organ ; 142: 23-31, 2020 Nov 05.
Artículo en Inglés | MEDLINE | ID: mdl-33150872

RESUMEN

Ingestion of abnormal materials by cetaceans has been reported worldwide, but few studies have investigated the causes of foreign material ingestion. We retrospectively analysed necropsies performed between 2012 and 2019 on 88 cetaceans stranded along the coast of Catalonia, Spain, and evaluated the association of abnormal ingested materials with 2 risk factors, namely disease of the central nervous system (CNS) and maternal separation. Abnormal materials were found in the digestive tract in 19 of 88 (21.6%) cetaceans; of these, 13 (60%) had lesions in the CNS, such as morbilliviral encephalitis, neurobrucellosis or encephalomalacia, and 3 were diagnosed as having experienced maternal separation. In a logistic regression model, CNS lesions and maternal separation were identified as risk factors for ingestion of foreign material, but with wide confidence intervals, probably due to the small sample size. In contrast, abnormal ingestion was not identified in any of the 25 (28%) cetaceans whose cause of death was attributed to interaction with humans. Abnormal ingestion should be interpreted with caution, and efforts should be made at necropsy to exclude CNS diseases through pathologic and microbiologic investigations. If disease of the CNS is a significant risk factor for ingestion of marine debris by small odontocetes, results of monitoring programmes may be biased by the prevalence of CNS disease in a specific area or population.


Asunto(s)
Privación Materna , Plásticos , Animales , Cetáceos , Estudios Retrospectivos , España/epidemiología
18.
Rev. clín. esp. (Ed. impr.) ; 220(8): 480-494, nov. 2020. tab, mapas
Artículo en Español | IBECS | ID: ibc-192204

RESUMEN

ANTECEDENTES: España ha sido uno de los países más afectados por la pandemia de COVID-19. OBJETIVO: Crear un registro de pacientes hospitalizados en España por COVID-19 para mejorar nuestro conocimiento sobre los aspectos clínicos, diagnósticos, terapéuticos y pronósticos de esta enfermedad. MÉTODOS: Estudio de cohorte retrospectiva, multicéntrico, que incluye pacientes consecutivos hospitalizados con COVID-19 confirmada en toda España. Se obtuvieron los datos epidemiológicos y clínicos, las pruebas complementarias al ingreso y a los 7 días de la admisión, los tratamientos administrados y la evolución a los 30 días de hospitalización de las historias clínicas electrónicas. RESULTADOS: Hasta el 30 de junio de 2020 se incluyeron 15.111 pacientes de 150 hospitales. Su mediana de edad fue 69,4 años (rango: 18-102 años) y el 57,2% eran hombres. Las prevalencias de hipertensión, dislipemia y diabetes mellitus fueron 50,9%, 39,7% y 19,4%, respectivamente. Los síntomas más frecuentes fueron fiebre (84,2%) y tos (73,5%). Fueron frecuentes los valores elevados de ferritina (73,5%), lactato deshidrogenasa (73,9%) y dímero D (63,8%), así como la linfopenia (52,8%). Los fármacos antivirales más utilizados fueron la hidroxicloroquina (85,6%) y el lopinavir/ritonavir (61,4%). El 33,1% desarrolló distrés respiratorio. La tasa de mortalidad global fue del 21,0%, con un marcado incremento con la edad (50-59 años: 4,7%; 60-69 años: 10,5%; 70-79 años: 26,9%; ≥80 años: 46%). CONCLUSIONES: El Registro SEMI-COVID-19 proporciona información sobre las características clínicas de los pacientes con COVID-19 hospitalizados en España. Los pacientes con COVID-19 hospitalizados en España son en su mayoría casos graves, ya que uno de cada 3 pacientes desarrolló distrés respiratorio y uno de cada 5 pacientes falleció. Nuestros datos confirman una estrecha relación entre la edad avanzada y la mortalidad


BACKGROUND: Spain has been one of the countries most affected by the COVID-19 pandemic. OBJECTIVE: To create a registry of patients with COVID-19 hospitalized in Spain, in order to improve our knowledge of the clinical, diagnostic, therapeutic, and prognostic aspects of this disease. METHODS: A multicentre retrospective cohort study, including consecutive patients hospitalized with confirmed COVID-19 throughout Spain. Epidemiological and clinical data, additional tests at admission and at seven days, treatments administered, and progress at 30 days of hospitalization were collected from electronic medical records. RESULTS: Up to June 30th 2020, 15,111 patients from 150 hospitals were included. Their median age was 69.4 years (range: 18-102 years) and 57.2% were male. Prevalences of hypertension, dyslipidemia, and diabetes mellitus were 50.9%, 39.7%, and 19.4%, respectively. The most frequent symptoms were fever (84.2%) and cough (73.5%). High values of ferritin (73.5%), lactate dehydrogenase (73.9%), and D-dimer (63.8%), as well as lymphopenia (52.8%), were frequent. The most used antiviral drugs were hydroxychloroquine (85.6%) and lopinavir/ritonavir (61.4%); 33.1% developed respiratory distress. Overall mortality rate was 21.0%, with a marked increase with age (50-59 years: 4.7%, 60-69 years: 10.5%, 70-79 years: 26.9%, ≥80 years: 46.0%). CONCLUSIONS: The SEMI-COVID-19 Network provides data on the clinical characteristics of patients with COVID-19 hospitalized in Spain. Patients with COVID-19 hospitalized in Spain are mostly severe cases, as one in three patients developed respiratory distress and one in five patients died. These findings confirm a close relationship between advanced age and mortality


Asunto(s)
Humanos , Masculino , Femenino , Adolescente , Adulto Joven , Adulto , Persona de Mediana Edad , Anciano , Anciano de 80 o más Años , Infecciones por Coronavirus/epidemiología , Síndrome Respiratorio Agudo Grave/epidemiología , Virus del SRAS/patogenicidad , Neumonía/epidemiología , España/epidemiología , Pacientes Internos/estadística & datos numéricos , Hospitalización/estadística & datos numéricos , Tiempo de Internación/estadística & datos numéricos , Estudios Retrospectivos , Registros de Enfermedades/estadística & datos numéricos
19.
Rev Infirm ; 69(264): 33-35, 2020 Oct.
Artículo en Francés | MEDLINE | ID: mdl-33129475

RESUMEN

Spain is one of the European countries most affected by COVID-19. The pandemic has had significant psychological consequences in the general population. Nurses involved in the management of this sudden and major health crisis were particularly impacted on a psychological level. In this article, a global overview is presented including negative and positive factors of the nurses' experiences in the two main cities of Spain affected by the virus: Madrid and Barcelona.


Asunto(s)
Betacoronavirus , Infecciones por Coronavirus , Pandemias , Neumonía Viral , Humanos , España/epidemiología
20.
PLoS One ; 15(10): e0241027, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33085729

RESUMEN

As the number of cases of COVID-19 continues to grow, local health services are at risk of being overwhelmed with patients requiring intensive care. We develop and implement an algorithm to provide optimal re-routing strategies to either transfer patients requiring Intensive Care Units (ICU) or ventilators, constrained by feasibility of transfer. We validate our approach with realistic data from the United Kingdom and Spain. In the UK, we consider the National Health Service at the level of trusts and define a 4-regular geometric graph which indicates the four nearest neighbours of any given trust. In Spain we coarse-grain the healthcare system at the level of autonomous communities, and extract similar contact networks. Through random search optimisation we identify the best load sharing strategy, where the cost function to minimise is based on the total number of ICU units above capacity. Our framework is general and flexible allowing for additional criteria, alternative cost functions, and can be extended to other resources beyond ICU units or ventilators. Assuming a uniform ICU demand, we show that it is possible to enable access to ICU for up to 1000 additional cases in the UK in a single step of the algorithm. Under a more realistic and heterogeneous demand, our method is able to balance about 600 beds per step in the Spanish system only using local sharing, and over 1300 using countrywide sharing, potentially saving a large percentage of these lives that would otherwise not have access to ICU.


Asunto(s)
Betacoronavirus , Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/terapia , Recursos en Salud/provisión & distribución , Modelos Teóricos , Neumonía Viral/epidemiología , Neumonía Viral/terapia , Algoritmos , Infecciones por Coronavirus/virología , Cuidados Críticos , Capacidad de Camas en Hospitales , Humanos , Unidades de Cuidados Intensivos/provisión & distribución , Pandemias , Transferencia de Pacientes , Neumonía Viral/virología , España/epidemiología , Reino Unido/epidemiología , Ventiladores Mecánicos/provisión & distribución
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