Risk factors for later hospitalization of patients discharged from an emergency department with nonsevere COVID-19 symptoms. / Factores de riesgo de rehospitalización en pacientes con COVID-19 leve tras el alta desde el servicio de urgencias.

OBJECTIVES: To describe the clinical course of patients discharged from the emergency department (ED) with nonsevere coronavirus disease 2019 (COVID-19) and explore possible risk factors for later hospitalization. MATERIAL AND METHODS: Patients with nonsevere COVID-19 who were discharged from the ED were included prospectively. We explored risk factors for hospitalization after discharge. RESULTS: Seventy-four patients were included; 17 (23%) were hospitalized after discharge. Three (4%) of the 17 patients died. Age, lymphopenia, a high Charlson Comorbidity Index, and a shorter delay between the onset of symptoms and the first visit to the ED were associated with hospitalization afterwards, although on multivariate analysis only time less than 6 days between symptom onset and the first ED visit was associated with later hospitalization (odds ratio, 4.62; 95% CI, 1.08-19.7). CONCLUSION: More than 20% of ED patients with nonsevere COVID-19 require hospitalization later.

OBJETIVO: Describir la evolución clínica de pacientes con COVID-19 leve tras el alta de urgencias y analizar los posibles factores de riesgo para una posterior hospitalización. METODO: Pacientes con COVID-19 leve dados de alta desde urgencias fueron prospectivamente incluidos. Los factores de riesgo de hospitalización fueron evaluados. RESULTADOS: Se incluyeron 74 pacientes y 17 (23%) requirieron hospitalización, de los cuales 3 (4%) fallecieron. La edad, la linfopenia, un mayor índice Charlson y un menor tiempo desde el inicio de los síntomas hasta la primera consulta a urgencias se asociaron a hospitalización, aunque en el análisis multivariado únicamente un tiempo desde el inicio de síntomas a la consulta a urgencias - 6 días se asoció a hospitalización (OR: 4,62: IC 95%: 1,08-19,7). CONCLUSIONES: Más del 20% de pacientes con COVID-19 leve dados de alta desde urgencias requiere hospitalización.

Factores de riesgo de rehospitalización en pacientes con COVID-19 leve tras el alta desde el servicio de urgencias / Risk factors for later hospitalization of patients discharged from an emergency department with non severe COVID-19 symptoms

OBJETIVO: Describir la evolución clínica de pacientes con COVID-19 leve tras el alta de urgencias y analizar los posibles factores de riesgo para una posterior hospitalización. MÉTODO: Pacientes con COVID-19 leve dados de alta desde urgencias fueron prospectivamente incluidos. Los factores de riesgo de hospitalización fueron evaluados. RESULTADOS: Se incluyeron 74 pacientes y 17 (23%) requirieron hospitalización, de los cuales 3 (4%) fallecieron. La edad, la linfopenia, un mayor índice Charlson y un menor tiempo desde el inicio de los síntomas hasta la primera consulta a urgencias se asociaron a hospitalización, aunque en el análisis multivariado únicamente un tiempo desde el inicio de síntomas a la consulta a urgencias < 6 días se asoció a hospitalización (OR: 4,62: IC 95%: 1,08-19,7). CONCLUSIONES: Más del 20% de pacientes con COVID-19 leve dados de alta desde urgencias requiere hospitalización

OBJETIVES: To describe the clinical course of patients discharged from the emergency department (ED) with non severe coronavirus disease 2019 (COVID-19) and explore possible risk factors for later hospitalization. METHODS: Patients with nonsevere COVID-19 who were discharged from the ED were included prospectively. We explored risk factors for hospitalization after discharge. RESULTS: Seventy-four patients were included; 17 (23%) were hospitalized after discharge. Three (4%) of the 17 patients died. Age, lymphopenia, a high Charlson Comorbidity Index, and a shorter delay between the onset of symptoms and the first visit to the ED were associated with hospitalization afterwards, although on multivariate analysis only time less than 6 days between symptom onset and the first ED visit was associated with later hospitalization (odds ratio, 4.62; 95% CI, 1.08-19.7). CONCLUSION: More than 20% of ED patients with nonsevere COVID-19 require hospitalization later

Asociación entre factores ambientales e ingresos por bronquiectasias en Badalona, Barcelona (2007-2015) / Association between environmental factors and hospitalisations for bronchiectasis in Badalona, Barcelona, Spain (2007-2015)

Introducción: La relación entre los factores ambientales y las exacerbaciones de enfermedades respiratorias ha sido ampliamente estudiada. No obstante, no existen estudios que analicen la relación entre la contaminación ambiental y las agudizaciones por bronquiectasias. El objetivo de nuestro estudio es analizar la asociación entre la contaminación ambiental y los ingresos por bronquiectasias. Material y métodos: Se trata de un estudio observacional y retrospectivo, realizado en 2 hospitales de Badalona. Se obtuvo el número de ingresos hospitalarios por agudización de bronquiectasias entre los años 2007 y 2015. Mediante regresión binomial negativa se analizó la posible influencia de la temperatura ambiental y los valores mensuales medios de dióxido de azufre (SO2), óxido nítrico, dióxido de nitrógeno, ozono y monóxido de carbono en el número de ingresos mensuales por bronquiectasias. Todos los p-valores se corrigieron por comparaciones múltiples. Resultados: Todos los factores analizados, pero especialmente la temperatura, se asociaron de forma estadísticamente significativa con el número de ingresos por exacerbación de bronquiectasias. Al controlar el efecto de la temperatura en las variables de contaminación, solamente el SO2 mantuvo la significación estadística (p=0,008). Conclusión: El número de ingresos hospitalarios por agudización de bronquiectasias parece ser mayor en los meses con bajas temperaturas y/o altas concentraciones de SO2. Se necesitan estudios prospectivos con diferentes áreas geográficas que confirmen estos resultados

Introduction: The relationship between environmental factors and the exacerbation of respiratory diseases has been widely studied. However, there are no studies examining the relationship between these factors and bronchiectasis exacerbations. Our objective was to analyse the association between various environmental factors and hospitalisation for bronchiectasis. Material and methods: This was a retrospective observational study conducted at two hospitals in Badalona (Barcelona). The number of hospital admissions for exacerbation of bronchiectasis between 2007 and 2015 was obtained. Through multiple regression we analysed the relationship between the number of exacerbations and mean monthly values of temperature, SO2, NO, NO2, O3 and CO. Results: Temperature, SO2, NO, NO2, O3 and CO were significantly associated with an increase in admissions due to exacerbation of bronchiectasis. By controlling the effect of temperature on the pollution variables, only SO2 maintained statistical significance (P=.008). Conclusion: We have detected an increase in hospital admissions for exacerbation of bronchiectasis with increases in the atmospheric concentration of SO2 and the decrease in temperature. Prospective studies with different geographical locations to confirm these results are needed

Association between environmental factors and hospitalisations for bronchiectasis in Badalona, Barcelona, Spain (2007-2015). / Asociación entre factores ambientales e ingresos por bronquiectasias en Badalona, Barcelona (2007-2015).

INTRODUCTION: The relationship between environmental factors and the exacerbation of respiratory diseases has been widely studied. However, there are no studies examining the relationship between these factors and bronchiectasis exacerbations. Our objective was to analyse the association between various environmental factors and hospitalisation for bronchiectasis. MATERIAL AND METHODS: This was a retrospective observational study conducted at two hospitals in Badalona (Barcelona). The number of hospital admissions for exacerbation of bronchiectasis between 2007 and 2015 was obtained. Through multiple regression we analysed the relationship between the number of exacerbations and mean monthly values of temperature, SO2, NO, NO2, O3 and CO. RESULTS: Temperature, SO2, NO, NO2, O3 and CO were significantly associated with an increase in admissions due to exacerbation of bronchiectasis. By controlling the effect of temperature on the pollution variables, only SO2 maintained statistical significance (P=.008). CONCLUSION: We have detected an increase in hospital admissions for exacerbation of bronchiectasis with increases in the atmospheric concentration of SO2 and the decrease in temperature. Prospective studies with different geographical locations to confirm these results are needed.