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2.
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
3.
Ann Med ; 53(1): 151-159, 2021 12.
Artículo en Inglés | MEDLINE | ID: mdl-33138653

RESUMEN

OBJECTIVE: To utilize publicly reported, state-level data to identify factors associated with the frequency of cases, tests, and mortality in the USA. MATERIALS AND METHODS: Retrospective study using publicly reported data collected included the number of COVID-19 cases, tests and mortality from March 14th through April 30th. Publicly available state-level data was collected which included: demographics comorbidities, state characteristics and environmental factors. Univariate and multivariate regression analyses were performed to identify the significantly associated factors with percent mortality, case and testing frequency. All analyses were state-level analyses and not patient-level analyses. RESULTS: A total of 1,090,500 COVID-19 cases were reported during the study period. The calculated case and testing frequency were 3332 and 19,193 per 1,000,000 patients. There were 63,642 deaths during this period which resulted in a mortality of 5.8%. Factors including to but not limited to population density (beta coefficient 7.5, p < .01), transportation volume (beta coefficient 0.1, p < .01), tourism index (beta coefficient -0.1, p = .02) and older age (beta coefficient 0.2, p = .01) are associated with case frequency and percent mortality. CONCLUSIONS: There were wide variations in testing and case frequencies of COVID-19 among different states in the US. States with higher population density had a higher case and testing rate. States with larger population of elderly and higher tourism had a higher mortality. Key messages There were wide variations in testing and case frequencies of COVID-19 among different states in the USA. States with higher population density had a higher case and testing rate. States with larger population of elderly and higher tourism had a higher mortality.


Asunto(s)
Técnicas de Laboratorio Clínico/estadística & datos numéricos , Infecciones por Coronavirus/mortalidad , Neumonía Viral/mortalidad , Comorbilidad , Infecciones por Coronavirus/diagnóstico , Femenino , Disparidades en Atención de Salud , Humanos , Masculino , Pandemias , Neumonía Viral/diagnóstico , Estados Unidos/epidemiología
4.
Ann Med ; 53(1): 78-86, 2021 12.
Artículo en Inglés | MEDLINE | ID: mdl-32997542

RESUMEN

BACKGROUND: Identification of patients with novel coronavirus disease 2019 (COVID-19) requiring hospital admission or at high-risk of in-hospital mortality is essential to guide patient triage and to provide timely treatment for higher risk hospitalized patients. METHODS: A retrospective multi-centre (8 hospital) cohort at Beaumont Health, Michigan, USA, reporting on COVID-19 patients diagnosed between 1 March and 1 April 2020 was used for score validation. The COVID-19 Risk of Complications Score was automatically computed by the EHR. Multivariate logistic regression models were built to predict hospital admission and in-hospital mortality using individual variables constituting the score. Validation was performed using both discrimination and calibration. RESULTS: Compared to Green scores, Yellow Scores (OR: 5.72) and Red Scores (OR: 19.1) had significantly higher odds of admission (both p < .0001). Similarly, Yellow Scores (OR: 4.73) and Red Scores (OR: 13.3) had significantly higher odds of in-hospital mortality than Green Scores (both p < .0001). The cross-validated C-Statistics for the external validation cohort showed good discrimination for both hospital admission (C = 0.79 (95% CI: 0.77-0.81)) and in-hospital mortality (C = 0.75 (95% CI: 0.71-0.78)). CONCLUSIONS: The COVID-19 Risk of Complications Score predicts the need for hospital admission and in-hospital mortality patients with COVID-19. Key points: Can an electronic health record generated risk score predict the risk of hospital admission and in-hospital mortality in patients diagnosed with coronavirus disease 2019 (COVID-19)? In both validation cohorts of 2,025 and 1,290 COVID-19, the cross-validated C-Statistics showed good discrimination for both hospital admission (C = 0.79 (95% CI: 0.77-0.81)) and in-hospital mortality (C = 0.75 (95% CI: 0.71-0.78)), respectively. The COVID-19 Risk of Complications Score may help predict the need for hospital admission if a patient contracts SARS-CoV-2 infection and in-hospital mortality for a hospitalized patient with COVID-19.


Asunto(s)
Betacoronavirus , Infecciones por Coronavirus/mortalidad , Enfermedad Crítica/mortalidad , Mortalidad Hospitalaria , Neumonía Viral/mortalidad , Adulto , Anciano , Estudios de Cohortes , Infecciones por Coronavirus/terapia , Enfermedad Crítica/terapia , Bases de Datos Factuales , Femenino , Humanos , Masculino , Persona de Mediana Edad , Pandemias , Neumonía Viral/terapia , Estudios Retrospectivos , Medición de Riesgo , Factores de Riesgo
5.
Goiânia; S.n; Dez. 04, 2020. 01-21 p. ilus, mapas, tab, graf.(Boletim Epidemiológico Covid-19, 35).
Monografía en Portugués | Coleciona SUS, CONASS, SES-GO | ID: biblio-1140324

RESUMEN

O Boletim epidemiológico COVID-19, da Secretaria de Estado da Saúde de Goiás (SES-GO), Brasil, objetiva apresentar as informações oficiais da situação epidemiológica do Estado, no período compreendido entre o registro dos primeiros casos suspeitos em Goiás, a partir de 04 de fevereiro até 28 de novembro de 2020. Nesta última semana epidemiológica (SE 48) houve a confirmação de 5.602 casos novos, representando uma redução de 0,3%. No Estado, 279.058 (34,9%) foram confirmados sendo 265.321 (95,1%) por critério laboratorial, 8.694 (3,1%) pelo critério clínico-epidemiológico, 1.370 (0,5%) por critério clínico-imagem e 3.047 (1,1%) pelo critério clínico, 273.106 (34,2%) foram descartados e 246.903 (30,9%) continuam como suspeitos. Na SE 48 foram realizados 839 testes (18,8% a mais do que na SE anterior), sendo 123 (14,7%) positivos, 714 (85,1%) negativos e dois inconclusivos (0,2)


The epidemiological bulletin COVID-19, of the State Department of Health of Goiás (SES-GO), Brazil, aims to present the official information of the epidemiological situation of the State, in the period between the record of the first suspected cases in Goiás, from February 4 to November 28, 2020. In this last epidemiological week (SE 48) there was the confirmation of 5,602 new cases, representing a reduction of 0.3%. In the State, 279,058 (34.9%) were confirmed with 265,321 (95.1%) by laboratory criterion, 8,694 (3.1%) by clinical and epidemiological criterion, 1,370 (0.5%) by clinical-imaging criterion and 3,047 (1.1%) by clinical criterion, 273,106 (34.2%) were discarded and 246,903 (30.9%) remain as suspects. In the SE 48, 839 tests were performed (18.8% more than in the previous SE), 123 (14.7%) positive, 714 (85.1%) negative and two inconclusive (0.2)


Asunto(s)
Humanos , Recién Nacido , Lactante , Preescolar , Niño , Adolescente , Adulto , Persona de Mediana Edad , Anciano , Anciano de 80 o más Años , Adulto Joven , Neumonía Viral/epidemiología , Infecciones por Coronavirus/epidemiología , Pandemias , Betacoronavirus , Neumonía Viral/diagnóstico , Neumonía Viral/mortalidad , Brasil/epidemiología , Incidencia , Infecciones por Coronavirus/diagnóstico , Infecciones por Coronavirus/mortalidad
7.
Porto Alegre; CEVS/RS; 2 dez. 2020. 1-25 p. ilus., graf., tab., mapas.
Monografía en Portugués | Coleciona SUS, CONASS, SES-RS | ID: biblio-1140668

RESUMEN

Neste boletim são apresentados: situação mundial, ocorrência de hospitalizações confirmadas para sars-cov-2, perfil das pessoas, distribuição espacial, Síndrome Inflamatória Multissistêmica Pediátrica (SIM-P), povos indígenas, descrição de surtos, trabalhadores da saúde, Vigilância sentinela de síndrome gripal etabelas de descrição do surto. (AU)


Asunto(s)
Humanos , Recién Nacido , Lactante , Preescolar , Niño , Adolescente , Adulto , Persona de Mediana Edad , Anciano , Anciano de 80 o más Años , Perfil de Salud , Mortalidad Hospitalaria/etnología , Personal de Salud/estadística & datos numéricos , Infecciones por Coronavirus/epidemiología , Grupos de Población/estadística & datos numéricos , Hospitalización/estadística & datos numéricos , Brotes de Enfermedades/estadística & datos numéricos , Infecciones por Coronavirus/mortalidad
8.
Goiânia; s.n; Dez. 11, 2020. 23 p. ilus, mapas, tab, graf.(Boletim Epidemiológico Covid-19, 36).
Monografía en Portugués | Coleciona SUS, CONASS, SES-GO | ID: biblio-1141363

RESUMEN

A Secretaria de Estado da Saúde de Goiás através da Superintendência de Vigilância em Saúde e Gerência de Vigilância Epidemiológica apresenta as informações atualizadas da situação epidemiológica COVID-19 no Estado de Goiás, Brasil, referente ao período de 04 de fevereiro a 05 de dezembro do ano de 2020. Informa que nesta semana (SE 49), 79 municípios registraram casos confirmados de COVID-19. Goiânia registrou o maior número de casos novos, 145 casos, seguida por Palmeiras de Goiás com 102, Morrinhos com 39 e Catalão com 30. Na SE 49 foram realizados 816 testes (2,7% a menos do que na SE anterior), sendo 134 (16,4%) positivos, 681 (83,5%) negativos e um inconclusivo


The State Department of Health of Goiás through the Superintendence of Health Surveillance and Epidemiological Surveillance Management presents the updated information of the epidemiological situation COVID-19 in the State of Goiás, Brazil, referring to the period from February 4 to December 5 of the year 2020. It reports that this week (SE 49), 79 municipalities recorded confirmed cases of COVID-19. Goiânia recorded the highest number of new cases, 145 cases, followed by Palmeiras de Goiás with 102, Morrinhos with 39 and Catalão with 30. In the SE 49, 816 tests were performed (2.7% less than in the previous SE), 134 (16.4%) positive, 681 (83.5%) negative and an inconclusive


Asunto(s)
Humanos , Recién Nacido , Lactante , Preescolar , Niño , Adolescente , Adulto , Persona de Mediana Edad , Anciano , Anciano de 80 o más Años , Adulto Joven , Neumonía Viral/epidemiología , Infecciones por Coronavirus/epidemiología , Pandemias , Betacoronavirus , Brasil/epidemiología , Incidencia , Infecciones por Coronavirus/diagnóstico , Infecciones por Coronavirus/mortalidad , Monitoreo Epidemiológico
9.
Goiânia; s.n; Dez. 12, 2020. 23 p. ilus, mapas, tab, graf.(Boletim Epidemiológico Covid-19, 37).
Monografía en Portugués | Coleciona SUS, CONASS, SES-GO | ID: biblio-1141416

RESUMEN

A Secretaria de Estado da Saúde de Goiás através da Superintendência de Vigilância em Saúde e Gerência de Vigilância Epidemiológica apresenta informações atualizadas da situação epidemiológica COVID-19 no Estado de Goiás, Brasil, referente ao período de 04 de fevereiro a 12 de dezembro de 2020. Conforme informação do Boletim, na SE 50, 7.490 casos evoluíram para cura, 2,6% a mais em relação à semana anterior. Na SE 50 foram notificados 416 novos casos de SRAG por COVID-19. Também na SE 50 foram realizados 516 testes (36,7% a menos do que na SE anterior), sendo 113(21,9%) positivos, 402 (77,9%) negativos e um inconclusivo (0,2)


A Secretaria de Estado da Saúde de Goiás através da Superintendência de Vigilância em Saúde e Gerência de Vigilância Epidemiológica apresenta informações atualizadas da situação epidemiológica COVID-19 no Estado de Goiás, Brasil, referente ao período de 04 de fevereiro a 12 de dezembro de 2020. Conforme informação do Boletim, na SE 50, 7.490 casos evoluíram para cura, 2,6% a mais em relação à semana anterior. Na SE 50 foram notificados 416 novos casos de SRAG por COVID-19. Também na SE 50 foram realizados 516 testes (36,7% a menos do que na SE anterior), sendo 113(21,9%) positivos, 402 (77,9%) negativos e um inconclusivo (0,2)


Asunto(s)
Humanos , Recién Nacido , Lactante , Preescolar , Niño , Adolescente , Adulto , Persona de Mediana Edad , Anciano , Anciano de 80 o más Años , Adulto Joven , Neumonía Viral/epidemiología , Infecciones por Coronavirus/epidemiología , Pandemias , Betacoronavirus , Brasil/epidemiología , Incidencia , Infecciones por Coronavirus/diagnóstico , Infecciones por Coronavirus/mortalidad
10.
Goiânia; s.n; Dez. 23, 2020. 23 p. ilus, mapas, tab, graf.(Boletim Epidemiológico Covid-19, 38).
Monografía en Portugués | Coleciona SUS, CONASS, SES-GO | ID: biblio-1141548

RESUMEN

A Secretaria de Estado da Saúde de Goiás através da Superintendência de Vigilância em Saúde e Gerência de Vigilância Epidemiológica apresenta informações atualizadas da situação epidemiológica da COVID-19 no Estado de Goiás, Brasil, referente ao período de 04 de fevereiro a 19 de dezembro de 2020. Conforme informação do Boletim, no Estado, 300.284 (34,8%) foram confirmados sendo 283.366 (94,4%) por critério laboratorial, 10.381 (3,5%) pelo critério clínico-epidemiológico, 1.658 (0,6%) por critério clínico-imagem e 4.271 (1,4%) pelo critério clínico, 309.420 (35,9%) foram descartados e 252.746 (29,3%) continuam como suspeitos. Nesta última semana epidemiológica (SE 51) houve a confirmação de 6.068 casos novos, representando um aumento de 2,1%


The State Department of Health of Goiás through the Superintendence of Health Surveillance and Epidemiological Surveillance Management presents updated information on the epidemiological situation of COVID-19 in the State of Goiás, Brazil, referring to the period from February 4 to December 19, 2020. According to the Bulletin, in the State, 300,284 (34.8%) were confirmed to be 283,366 (94.4%) by laboratory criterion, 10,381 (3.5%) by clinical and epidemiological criterion, 1,658 (0.6%) by clinical-imaging criterion and 4,271 (1.4%) by clinical criterion, 309,420 (35.9%) were discarded and 252,746 (29.3%) remain suspicious. In this last epidemiological week (SE 51) there was confirmation of 6,068 new cases, representing an increase of 2.1%


Asunto(s)
Humanos , Recién Nacido , Lactante , Preescolar , Niño , Adolescente , Adulto , Persona de Mediana Edad , Anciano , Anciano de 80 o más Años , Adulto Joven , Neumonía Viral/epidemiología , Infecciones por Coronavirus/epidemiología , Pandemias , Betacoronavirus , Neumonía Viral/diagnóstico , Neumonía Viral/mortalidad , Brasil/epidemiología , Incidencia , Infecciones por Coronavirus/diagnóstico , Infecciones por Coronavirus/mortalidad , Monitoreo Epidemiológico
11.
Rev. esp. anestesiol. reanim ; 67(10): 556-558, dic. 2020. ilus, graf
Artículo en Español | IBECS | ID: ibc-195348

RESUMEN

La mayoría de la bibliografía mundial sobre la pandemia Covid-19 se ha focalizado en los países del continente asiático, europeo o americano. En África parece que la incidencia es menor. En este artículo se hipotetiza sobre alguna de las posibles causas que han dado lugar a estas diferencias. La pirámide poblacional, la temperatura ambiente, la vulnerabilidad/resistencia de los habitantes del continente o factores sociopolíticos son subrayados. En caso de que la pandemia se extendiera en el continente africano, posiblemente la falta de recursos sanitarios haría que las consecuencias fueran desastrosas y de una magnitud dantesca


Most of the international bibliography published on Covid-19 pandemics is focused in the Asian, European or American continents. It seems that incidence is lower in Africa. In this article we hypothetize on several of the possible causes sustaining these differences. Population pyramid, climate, african population own vulnerability/resistance or sociopolitical factors are underlined. In the case the pandemics will spread in Africa, the lack of basic healthcare resources will perhaps make the consequences disastrous and of a dantesque magnitude


Asunto(s)
Humanos , Infecciones por Coronavirus/epidemiología , Neumonía Viral/epidemiología , Pandemias , Infecciones por Coronavirus/mortalidad , Infecciones por Coronavirus/prevención & control , Neumonía Viral/mortalidad , Neumonía Viral/prevención & control , Congo/epidemiología , África/epidemiología , Factores de Edad , Incidencia , Temperatura
12.
Neurología (Barc., Ed. impr.) ; 35(9): 0-0, nov.-dic. 2020. tab
Artículo en Español | IBECS | ID: ibc-194160

RESUMEN

INTRODUCTION: The elderly population is the group most threatened by COVID-19, with the highest mortality rates. This study aims to analyse the case fatality of COVID-19 in a cohort of patients with degenerative dementia. METHODS: We conducted a descriptive case-control study of a sample of patients diagnosed with primary neurodegenerative dementia. RESULTS: Twenty-four of the 88 patients with COVID-19 included in the study died: 10/23 (43.4%) patients diagnosed with dementia and 14/65 (21.5%) controls; this difference was statistically significant. DISCUSSION: Our results suggest that case fatality of COVID-19 is significantly higher among patients with primary degenerative dementia than in other patients with similar mean ages and comorbidities


INTRODUCCIÓN: La población anciana es la más amenazada por COVID-19, con mayores tasas de mortalidad. El objetivo de este trabajo es analizar la letalidad en una cohorte de pacientes de COVID-19 con demencia degenerativa. MÉTODOS: Hicimos un estudio descriptivo de casos-control de una muestra de pacientes diagnosticados con demencias neurodegenerativas primarias. RESULTADOS: De los 88 pacientes incluidos en el estudio, 24 pacientes con COVID-19 fallecieron: 10/23 (43,4%) eran pacientes con diagnóstico de demencia y 14/65 (21,5%) pacientes del grupo control, una diferencia estadísticamente significativa. DISCUSIÓN: La letalidad entre los pacientes con demencia degenerativa primaria por COVID-19 es significativamente mayor en comparación con otros pacientes con edades medias y comorbilidades similares, según nuestro estudio


Asunto(s)
Humanos , Masculino , Femenino , Anciano , Anciano de 80 o más Años , Enfermedades Neurodegenerativas/mortalidad , Enfermedades Neurodegenerativas/virología , Infecciones por Coronavirus/mortalidad , Neumonía Viral/complicaciones , Neumonía Viral/mortalidad , Pandemias , Demencia/virología , Estudios de Casos y Controles , Factores de Riesgo
13.
An. pediatr. (2003. Ed. impr.) ; 93(6): 420.e1-420.e6, dic. 2020.
Artículo en Español | IBECS | ID: ibc-192559

RESUMEN

Con más de 575.000 muertes y cerca de 13,3 millones de casos a nivel global, la pandemia por COVID-19ha causado un terrible impacto en apenas medio año de evolución desde que por primera vez fuesen detectados casos en China. Conscientes de las dificultades planteadas en entornos con sistemas de salud robustos, donde la mortalidad ha sido significativa, y la transmisión difícilmente controlable, había una lógica preocupación por ver cómo el virus podría afectar a los países africanos, donde sus frágiles sistemas de salud auguraban un impacto aún mayor. Este «tsunami» anunciado, de potenciales consecuencias devastadoras, parece, sin embargo, no haber llegado todavía, y los países africanos, donde ya se ha evidenciado una creciente transmisión, no están viendo el impacto en la salud de sus habitantes que muchos habían predicho. En este artículo repasamos la situación actual de la pandemia en el continente africano, intentando entender los determinantes de su lenta progresión


With over 575,000 deaths and about 13.3 million cases globally, the COVID-19 pandemic has had a terrible impact globally during the 6 months since cases were first detected in China. Conscious of the many challenges presented in settings with abundance of resources and with robust health systems, where mortality has been significant and transmission difficult to control, there was a logical concern to see how the virus could impact African countries, and their fragile and weak health systems. Such an anticipated "tsunami", with potentially devastating consequences, seems however to not have yet arrived, and African countries, albeit witnessing an increasing degree of autochthonous transmission, seem to this day relatively unaffected by the pandemic. In this article we review the current situation of the pandemic in the African continent, trying to understand the determinants of its slow progress


Asunto(s)
Humanos , Infecciones por Coronavirus/epidemiología , Neumonía Viral/epidemiología , Pandemias , Infecciones por Coronavirus/economía , Infecciones por Coronavirus/mortalidad , Neumonía Viral/economía , Neumonía Viral/mortalidad , África/epidemiología
14.
Rev. esp. geriatr. gerontol. (Ed. impr.) ; 55(6): 317-325, nov.-dic. 2020. tab
Artículo en Español | IBECS | ID: ibc-192480

RESUMEN

ANTECEDENTES Y OBJETIVO: La pandemia por SARS-CoV-2 condiciona elevadas tasas de mortalidad en pacientes mayores hospitalizados. Actualmente, pocos estudios incluyen pacientes octogenarios y ninguno analiza el impacto del estado funcional sobre este resultado de salud. Nuestro objetivo es describir las características de los pacientes mayores de 80 años hospitalizados por coronavirus disease 2019 (COVID-19), determinar la tasa de mortalidad e identificar factores asociados. MATERIALES Y MÉTODOS: Estudio observacional prospectivo realizado en mayores de 80 años ingresados por COVID-19 en un Servicio de Geriatría. Se recogieron variables sociodemográficas, clínicas, funcionales, mentales, analíticas, radiológicas, terapéuticas y asistenciales. Se analizaron mediante análisis bivariante los factores asociados a mortalidad intrahospitalaria. RESULTADOS: Fueron incluidos 58 casos con COVID-19 confirmado por laboratorio, edad media 88,3 ± 5,4 años, 69% mujeres, 65,5% deterioro cognitivo moderado-severo e índice de Barthel previo 40,6 ± 36. Los principales síntomas fueron fiebre (60,3%), disnea (53,4%) y deterioro del estado funcional (50%). Las comorbilidades más frecuentes fueron enfermedad cardiovascular (75,9%), hipertensión arterial (HTA) (74,1%) y enfermedad renal crónica (ERC) (50%). Se detectó una tasa de mortalidad del 41,4%, siendo los factores asociados: dependencia funcional severa (OR = 3,8 [1,2-12,2]), ERC (OR = 3,2 [1,1-9,7]), deterioro cognitivo moderado-severo (OR = 4,9 [1 a 25,4]). CONCLUSIONES: Se objetivan altas tasas de mortalidad en pacientes mayores hospitalizados por COVID-19, con mayor riesgo de fallecer en aquellos con dependencia funcional severa o deterioro cognitivo. Estos hallazgos refuerzan la importancia de la Valoración Geriátrica para elaborar estrategias que permitan adecuar la toma de decisiones diagnósticas y terapéuticas y optimizar la atención al paciente anciano ante un nuevo brote epidémico


OBJECTIVE: The SARS-CoV-2 pandemic conditions high mortality rates in hospitalized elderly. Currently, a few studies include octogenarian patients and none of them analyze the impact of functional status on this health outcome. Our objective is to describe the characteristics of patients older than 80 years hospitalized for coronavirus disease 2019 (COVID-19), to determine the mortality rate and to identify associated factors. MATERIAL AND METHODS: Prospective observational study carried out on patients over 80 years admitted for COVID-19 in a Geriatrics Service. Sociodemographic, clinical, functional, mental, analytical, radiological, therapeutic and healthcare variables were collected. The factors associated with in-hospital lethality were analyzed by bivariate analysis. RESULTS: 58 cases with laboratory-confirmed COVID-19 were included, mean age 88.3 ± 5.4 years, 69% women, 65.5% moderate-severe cognitive impairment and previous Barthel index 40.66 ± 36. The main symptoms were fever (60,3%), dyspnea (53.4%) and deterioration of functional condition (50%). The most frequent comorbidities were cardiovascular disease (75.9%), hypertension (HT) (74.1%) and chronic kidney disease (CKD) (50%). A mortality rate of 41,4% was detected and the associated factors were: severe functional dependence (OR = 3.8 [1.2-12.2]), moderate-severe cognitive impairment (OR = 4.9 [1-25.4]) and CKD (OR = 3.2 [1.1-9.7]). CONCLUSION: High mortality rates are observed in older patients hospitalized for COVID-19, with a higher risk of dying in those with severe functional dependence or cognitive impairment. These findings reinforce the value of Geriatric Assessment to develop strategies to adapt diagnostic and therapeutic decision-making and to optimize care for elderly patients in the event of a new epidemic outbreak


Asunto(s)
Humanos , Masculino , Femenino , Anciano de 80 o más Años , Infecciones por Coronavirus/mortalidad , Mortalidad Hospitalaria/tendencias , Virus del SRAS/aislamiento & purificación , Estudios Prospectivos , Indicadores de Morbimortalidad , Causas de Muerte/tendencias , Anciano Frágil/estadística & datos numéricos
15.
Rev. Hosp. Ital. B. Aires (2004) ; 40(4): 185-190, dic. 2020.
Artículo en Español | LILACS | ID: biblio-1145464

RESUMEN

Esta revisión narrativa describe el daño colateral de la pandemia de COVID-19, tanto en aspectos de la salud, como también sociales, educativos o económicos. Comunicamos el impacto mundial y local. Consideramos que varias de estas consecuencias eran inevitables, especialmente las sucedidas durante los primeros meses de una pandemia que se difundió a gran velocidad y con graves consecuencias directas en la morbimortalidad de la población. Sin embargo, luego de seis meses de su llegada a la Argentina, es oportuno revaluar la situación y replantearse si no se debería cambiar el enfoque para balancear la minimización del impacto directo de COVID-19 junto con la del daño colateral que las medidas para paliarlo produjeron. Es un desafío que no debe limitarse al sistema de salud. Debe encararse con un abordaje intersectorial amplio y con participación activa de la sociedad. Así como aplanamos la curva de COVID-19, cuanto más nos demoremos en aplanar las otras curvas de problemas sanitarios y sociales que se están generando, mayor será su impacto, tanto en el corto como en el largo plazo. (AU)


This narrative review shows the collateral damage of the COVID-19 pandemic, whether in health, social, educational or economic aspects. We report on the impact at the global and local levels. Many of these consequences were inevitable, especially in the first months of a pandemic that spread at great speed and with serious direct consequences on the morbidity and mortality of the population. However, six months after the arrival in our country, it is an opportunity to reassess the situation and rethink whether the approach should not be changed to balance the minimization of the direct impact of COVID-19 with that of the collateral damage that mitigation measures produced. This is a challenge that should not be limited to the health system. It must be addressed with a broad intersectoral approach and active participation of society. Just as we flatten the COVID-19 curve, the longer we delay in flattening the other curves of health and social problems that are being generated, the greater the impact, both in the short and long term. (AU)


Asunto(s)
Humanos , Neumonía Viral/economía , Infecciones por Coronavirus/economía , Determinantes Sociales de la Salud/estadística & datos numéricos , Argentina , Neumonía Viral/mortalidad , Neumonía Viral/psicología , Calidad de Vida , Aislamiento Social , Problemas Sociales/prevención & control , Problemas Sociales/estadística & datos numéricos , Estrategias Nacionales , Sistemas de Salud/tendencias , Indicadores de Morbimortalidad , Mortalidad , Infecciones por Coronavirus/mortalidad , Infecciones por Coronavirus/psicología , Impactos en la Salud/estadística & datos numéricos , Equidad en el Acceso a los Servicios de Salud , Análisis de las Consecuencias , Comunicación en Salud/métodos , Pandemias/estadística & datos numéricos
16.
Bogotá; Organización Panamericana de la Salud; dic. 05, 2020. 7 p.
No convencional en Español | LILACS | ID: biblio-1140276

RESUMEN

A la fecha Colombia reporta 1.334.089 casos (9.297 casos nuevos en las últimas 24h) con un incremento nacional del 0,7% en las últimas 24h y 37.117 defunciones (183 las últimas 24 Horas) con un aumento nacional del 0,5% en las últimas 24h. Los departamentos y distritos que presentaron los aumentos relativos más altos de COVID-19 en los últimos 7 días fueron: Caldas 11,9% (2.070), Quindío 11,5% (1.397), Tolima 11,5% (2.445), Norte Santander 10,3% (2.075), Boyacá 9,3% (1.302), Casanare 9,0% (504), Cartagena 8,7% (2.044), Risaralda 7,8% (1.297), Santa Marta 7,3% (765), Santander 7,1% (2.658). La tasa de incidencia nacional es de 2.648,5 casos por cada 100.000 habitantes; los departamentos y/o distritos que superan la tasa nacional son en su orden: Bogotá (4.905,8), Amazonas (3.992,7), Barranquilla (3.590,0), San Andrés (3.433,7), Caquetá (3.275,8), Antioquia (3.247,0), Quindío (3.157,9), Cartagena (3.107,4), Huila (2.713,3), Meta (2.686,8). La tasa de mortalidad nacional es de 736,9 muertes por cada millón de habitantes; se observa una tasa de mortalidad mayor a la nacional en: Amazonas (1.556,6), Barranquilla (1.375,7), Caquetá (1.169,2), Bogotá (1.110,5), Santa Marta (943,2), Córdoba (904,3), Santander (893,5), Huila (870,3), Norte Santander (865,9), Quindío (831,8), Valle del Cauca (778,9).


Asunto(s)
Humanos , Masculino , Femenino , Niño , Adolescente , Adulto , Persona de Mediana Edad , Neumonía Viral/mortalidad , Infecciones por Coronavirus/mortalidad , Tormentas Ciclónicas/estadística & datos numéricos , Pandemias/prevención & control , Desastres Naturales/mortalidad , Colombia/epidemiología
17.
Bogotá; Organización Panamericana de la Salud; dic 08, 2020. 8 p.
No convencional en Español | LILACS | ID: biblio-1140725

RESUMEN

Este es el reporte de situación COVID-19 Colombia No. 192 - 08 de diciembre de 2020.


Asunto(s)
Humanos , Masculino , Femenino , Adulto , Persona de Mediana Edad , Neumonía Viral/mortalidad , Infecciones por Coronavirus/mortalidad , Pandemias/estadística & datos numéricos , Colombia/epidemiología
18.
Euro Surveill ; 25(48)2020 12.
Artículo en Inglés | MEDLINE | ID: mdl-33272355

RESUMEN

BackgroundIn March 2020, the COVID-19 outbreak was declared a pandemic by the World Health Organization.AimOur objective was to identify risk factors predictive of severe disease and death in France.MethodsIn this prospective cohort study, we included patients ≥ 18 years old with confirmed COVID-19, hospitalised in Strasbourg and Mulhouse hospitals (France), in March 2020. We respectively compared patients who developed severe disease (admission to an intensive care unit (ICU) or death) and patients who died, to those who did not, by day 7 after hospitalisation.ResultsAmong 1,045 patients, 424 (41%) had severe disease, including 335 (32%) who were admitted to ICU, and 115 (11%) who died. Mean age was 66 years (range: 20-100), and 612 (59%) were men. Almost 75% of patients with body mass index (BMI) data (n = 897) had a BMI ≥ 25 kg/m2 (n = 661). Independent risk factors associated with severe disease were advanced age (odds ratio (OR): 1.1 per 10-year increase; 95% CrI (credible interval): 1.0-1.2), male sex (OR: 2.1; 95% CrI: 1.5-2.8), BMI of 25-29.9 kg/m2 (OR: 1.8; 95% CrI: 1.2-2.7) or ≥ 30 (OR: 2.2; 95% CrI: 1.5-3.3), dyspnoea (OR: 2.5; 95% CrI: 1.8-3.4) and inflammatory parameters (elevated C-reactive protein and neutrophil count, low lymphocyte count). Risk factors associated with death were advanced age (OR: 2.7 per 10-year increase; 95% CrI: 2.1-3.4), male sex (OR: 1.7; 95% CrI: 1.1-2.7), immunosuppression (OR: 3.8; 95% CrI: 1.6-7.7), diabetes (OR: 1.7; 95% CrI: 1.0-2.7), chronic kidney disease (OR: 2.3; 95% CrI: 1.3-3.9), dyspnoea (OR: 2.1; 95% CrI: 1.2-3.4) and inflammatory parameters.ConclusionsOverweightedness, obesity, advanced age, male sex, comorbidities, dyspnoea and inflammation are risk factors for severe COVID-19 or death in hospitalised patients. Identifying these features among patients in routine clinical practice might improve COVID-19 management.


Asunto(s)
Infecciones por Coronavirus/diagnóstico , Coronavirus/aislamiento & purificación , Unidades de Cuidados Intensivos/estadística & datos numéricos , Admisión del Paciente/estadística & datos numéricos , Neumonía Viral/diagnóstico , Adolescente , Adulto , Factores de Edad , Anciano , Anciano de 80 o más Años , Comorbilidad , Infecciones por Coronavirus/mortalidad , Infecciones por Coronavirus/terapia , Disnea/epidemiología , Femenino , Francia/epidemiología , Humanos , Inflamación/epidemiología , Masculino , Persona de Mediana Edad , Obesidad/epidemiología , Pandemias , Neumonía Viral/mortalidad , Neumonía Viral/terapia , Estudios Prospectivos , Factores de Riesgo , Índice de Severidad de la Enfermedad , Factores Sexuales , Análisis de Supervivencia , Adulto Joven
19.
Ren Fail ; 43(1): 1-15, 2020 Nov 09.
Artículo en Inglés | MEDLINE | ID: mdl-33256491

RESUMEN

OBJECTIVES: A meta-analysis and systematic review was conducted on kidney-related outcomes of three recent pandemics: SARS, MERS, and COVID-19, which were associated with potentially fatal acute respiratory distress syndrome (ARDS). METHODS: A search of all published studies until 16 June 2020 was performed. The incidence/prevalence and mortality risk of acute and chronic renal events were evaluated, virus prevalence, and mortality in preexisting hemodialysis patients was investigated. RESULTS: A total of 58 eligible studies involving 13452 hospitalized patients with three types of coronavirus infection were included. The reported incidence of new-onset acute kidney injury (AKI) was 12.5% (95% CI: 7.6%-18.3%). AKI significantly increased the mortality risk (OR = 5.75, 95% CI 3.75-8.77, p < 0.00001) in patients with coronavirus infection. The overall rate of urgent-start kidney replacement therapy (urgent-start KRT) use was 8.9% (95% CI: 5.0%-13.8%) and those who received urgent-start KRT had a higher risk of mortality (OR = 3.43, 95% CI 2.02-5.85, p < 0.00001). Patients with known chronic kidney disease (CKD) had a higher mortality than those without CKD (OR = 1.97, 95% CI 1.56-2.49, p < 0.00001). The incidence of coronavirus infection was 7.7% (95% CI: 4.9%-11.1%) in prevalent hemodialysis patients with an overall mortality rate of 26.2% (95% CI: 20.6%-32.6%). CONCLUSIONS: Primary kidney involvement is common with coronavirus infection and is associated with significantly increased mortality. The recognition of AKI, CKD, and urgent-start KRT as major risk factors for mortality in coronavirus-infected patients are important steps in reducing future mortality and long-term morbidity in hospitalized patients with coronavirus infection.


Asunto(s)
Lesión Renal Aguda , Infecciones por Coronavirus , Fallo Renal Crónico , Síndrome Respiratorio Agudo Grave , Lesión Renal Aguda/epidemiología , Lesión Renal Aguda/terapia , Lesión Renal Aguda/virología , /fisiopatología , Coronavirus , Infecciones por Coronavirus/mortalidad , Infecciones por Coronavirus/fisiopatología , Humanos , Incidencia , Fallo Renal Crónico/epidemiología , Fallo Renal Crónico/terapia , Fallo Renal Crónico/virología , Pandemias/estadística & datos numéricos , Terapia de Reemplazo Renal/estadística & datos numéricos , Factores de Riesgo , Síndrome Respiratorio Agudo Grave/mortalidad , Síndrome Respiratorio Agudo Grave/fisiopatología
20.
Crit Care ; 24(1): 647, 2020 11 16.
Artículo en Inglés | MEDLINE | ID: mdl-33198786

RESUMEN

BACKGROUND: Coronavirus disease 2019 (COVID-19), a highly infectious disease, has been rapidly spreading all over the world and remains a great threat to global public health. Patients diagnosed with severe or critical cases have a poor prognosis. Hence, it is crucial for us to identify potentially severe or critical cases early and give timely treatments for targeted patients. In the clinical practice of treating patients with COVID-19, we have observed that the neutrophil-to-lymphocyte ratio (NLR) of severe patients is higher than that in mild patients. We performed this systematic review and meta-analysis to evaluate the predictive values of NLR on disease severity and mortality in patients with COVID-19. METHODS: We searched PubMed, EMBASE, China National Knowledge Infrastructure (CNKI) and Wanfang databases to identify eligible studies (up to August 11, 2020). Two authors independently screened studies and extracted data. The methodological quality of the included studies was assessed by Quality Assessment of Diagnostic Accuracy Studies 2 (QUADAS-2). RESULTS: Thirteen studies involving 1579 patients reported the predictive value of NLR on disease severity. The pooled sensitivity (SEN), specificity (SPE) and area under curve (AUC) were 0.78 (95% CI 0.70-0.84), 0.78 (95% CI 0.73-0.83) and 0.85 (95% CI 0.81-0.88), respectively. Ten studies involving 2967 patients reported the predictive value of NLR on mortality. The pooled SEN, SPE and AUC were 0.83 (95% CI 0.75-0.89), 0.83 (95% CI 0.74-0.89) and 0.90 (95% CI 0.87-0.92), respectively. CONCLUSIONS: NLR has good predictive values on disease severity and mortality in patients with COVID-19 infection. Evaluating NLR can help clinicians identify potentially severe cases early, conduct early triage and initiate effective management in time, which may reduce the overall mortality of COVID-19. TRIAL REGISTRY: This meta-analysis was prospectively registered on PROSPERO database (Registration number: CRD42020203612).


Asunto(s)
Betacoronavirus , Infecciones por Coronavirus/sangre , Infecciones por Coronavirus/diagnóstico , Linfocitos/metabolismo , Neutrófilos/metabolismo , Neumonía Viral/sangre , Neumonía Viral/diagnóstico , Índice de Severidad de la Enfermedad , Infecciones por Coronavirus/mortalidad , Humanos , Mortalidad/tendencias , Pandemias , Neumonía Viral/mortalidad
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