Can we still consider treatment with colchicine effective in SARS-COV-2 infection? Systematic review, meta-analysis, and trial sequential analysis.

OBJECTIVE: To assess the effectiveness of colchicine, compared with standard of care, for reducing mortality, admission to intensive care, and use of mechanical ventilation. MATERIALS AND METHODS: We performed a systematic review, meta-analysis, and sequential trial analysis. The terms (SARS-CoV-2 OR COVID-19 OR coronavirus) AND (colchicine) were searched in MEDLINE, Scopus, Embase, Cochrane Central Register of Controlled Trials, and preprint repositories (February 2020 to April 2021, extended to June 2021). Risk of bias for randomised controlled trials and observational studies were assessed using the tools RoB 2.0 and ROBINS-I, respectively. We performed subgroup analyses based on study design and sensitivity analyses based on time of colchicine administration. RESULTS: We included six observational studies (1329 patients) and five clinical trials (16,048 patients). All studies but one were conducted in the hospital setting. Colchicine treatment was not associated with a significant decrease in mortality (RR 0.93, 95% CI 0.87 to 1; p=0.06, I2=72%) with a significant subgroup effect (p<0.001) depending on the design of the studies. The drug was effective in observational studies (RR 0.57, 95% CI 0.46 to 0.70, p<0.001, I2=50%) but not in clinical trials (RR 0.99, 95% CI 0.92 to 1.07, p=0.89, I2=21%). The effect of colchicine on intensive care admissions and the need for mechanical ventilation could not be confirmed. Trial sequential boundaries for cumulative meta-analyses of randomised controlled trials suggested no significant effect on mortality (p=0.182) beyond the optimal information size (13,107 patients). CONCLUSIONS: Our results suggest that colchicine treatment has no effect on mortality in hospitalised patients with SARS-CoV-2 infection, and that no further confirmatory clinical trials are needed owing to futility.

[Life-style and self-rated health status, and the use of health services by an immigrant population from Paraguay and Bolivia in city of Elche (Alicante, Spain)]. / Estilos de vida, salud autopercibida y utilización de los servicios sanitarios en inmigrantes de Paraguay y Bolivia residentes en la ciudad de Elche.

OBJECTIVE: To study the lifestyle, use of health services, self-perceived health status and health services evaluations of immigrants from Paraguay and Bolivia in the city of Elche, and to establish and/or adapt prevention health services strategies to the needs of this population. METHODS: A cross-sectional study, using a health questionnaire, was conducted between November 2009 and April 2010, using a convenience sample selected from the Paraguay and Bolivia Citizens Association. RESULTS: A total of 49 Paraguayans and 35 Bolivians over 15 years old were interviewed of whom 42 (50%) were male; 33% of respondents did not perform any physical activity, and 14.3% were smokers (males [23.8%] vs female [4.8%], P=.03). The assessment of health was good or very good in 59.5% (Paraguayans [71.4%] vs Bolivians [42.9%]), P=.02). The use of health services was 85.4% (males [75%] vs women [95.2%], P=02) and 51% went to an emergency department. Consultation with a dentist was reported in 43.9% (Paraguayans [56.2%] vs Bolivians [26.5%], P=.007); 65.9% considered the Spanish public health system as being excellent, very good or good. CONCLUSION: The lifestyle, the use of private resources and the assessment of health status are different in both groups studied. The assessment of the Spanish public health system was good in both. Strategies are needed to improve lifestyle, counselling for smoking cessation, alcohol use and control of dyslipidaemia.

[Short-Stay Medical Unit, an alternative to conventional hospitalization]. / Unidad Médica de Corta Estancia, una alternativa a la hospitalización convencional.

BACKGROUND: The Short-Stay Medical Unit (SSMU) is an alternative to conventional hospitalization. This study has aimed to analyze the evolution of admissions and duration of stay in a SSMU, to outline the characteristics of the patients while studying their relationship to length of time spent in the unit and their destination on discharge as well as to assess how appropriately their cases were resolved. MATERIAL AND METHODS: A descriptive study was carried out (2000-2005), analyzing their age, sex, destination on discharge and main diagnosis as well as the evolution of admissions and length of stay over this period. In order to determine how appropriately each case was resolved, length of stay and destination on discharge were considered. The data were analyzed using the SPSS program. RESULTS: During the study period there was an increase in the number of admissions and in length of stay. The average age of the 7,618 patients was 70.6 +/- 16.9 years and the average stay 2.7 +/- 1.4 days. One of the most frequent diagnoses was chronic obstructive pulmonary disease (COPD) (15.9%). On discharge, 85.9% of patients were sent home. A total of 76.4% of cases were resolved satisfactorily, with significant statistical differences related to age, diagnosis and number of diagnoses. CONCLUSIONS: A progressive increase in admissions and length of stay was observed. Ninety percent of the cases of the younger patients were resolved satisfactorily, this decreasing to 72% for older patients. The number of diagnoses, specific diagnoses and age caused some difficulty in reaching an appropriate resolution.