ABSTRACT
Objetivo: avaliar o impacto da pandemia de COVID-19 na qualidade de vida em geral dos profissionais de saúde da Atenção Primária de Fortaleza. Métodos: estudo transversal e quantitativo, com a aplicação do questionário MEDICAL OUTCOMES STUDY 36-ITEM SHORT-FORM HEALTH SURVEY, entre os trabalhadores das Unidades de Atenção Primária da Regional II. Resultados: foi obtida uma amostra de 146 pessoas, sendo mais de 70% do sexo feminino, com média de idade de 40 anos. Do total, 65,8% apresentaram histórico de infecção por COVID-19 e apenas 3 foram internados. quando comparado às médias brasileiras, na amostra estudada foram encontradas médias mais elevadas em capacidade funcional (82,5 (18,05)) e aspectos físicos (78,3 (31,39)) e menores média nos tópicos de aspectos sociais (41,9 (25,87)) e dor (51,1 (40,94)). Quando comparados os profissionais de acordo com o tempo de trabalho, aqueles com mais de 5 anos de profissão destacaram-se em aspectos físicos (81,6(30,91)) (p=0,0074), vitalidade (60,5(23,34)) (p=0,0097) e saúde mental (70,5(20,32)) (p=0,0131). Conclusão: os profissionais de saúde da atenção primária, que atuavam na regional 2, apresentaram menor qualidade de vida, porém não é possível relacionar diretamente com a infecção pelo vírus.
Objective: to evaluate the impact of the COVID-19 pandemic on the quality of life of health professionals in the Primary Care of Fortaleza. Methods: cross-sectional and quantitative study, applying the MEDICAL OUTCOMES STUDY 36-ITEM SHORT-FORM HEALTH SURVEY questionnaire, among workers of the Primary Care Units of Regional II. Results: A total sample of 146 participants was obtained, with over 70% being female and an average age of 40 years. Among the participants, 65.8% reported a history of COVID-19 infection, with only three requiring hospitalization. When compared to Brazilian population norms, the study sample exhibited higher mean scores in functional capacity (82.5 (18.05)) and physical aspects (78.3 (31.39)), and lower mean scores in social aspects (41.9 (25.87)) and pain (51.1 (40.94)). When comparing professionals based on years of service, those with over five years of experience showed significantly better scores in physical aspects (81.6 (30.91)) (p=0.0074), vitality (60.5 (23.34)) (p=0.0097), and mental health (70.5 (20.32)) (p=0.0131). Conclusion: Healthcare professionals in Primary Care from Regional II presented a lower overall quality of life. However, a direct correlation with COVID-19 infection could not be established
Subject(s)
Humans , Male , Female , Adult , Quality of Life , Mental Health , Health Personnel , Primary Health Care , Work , Health , Delivery of Health Care , COVID-19ABSTRACT
O presente estudo tem por objetivo realizar um relato de experiência demonstrando a percepção de discentes do curso de odontologia na sua participação na prática da atenção primária à saúde (APS), vivenciadas em um cenário pandêmico e com base no combate a enfrentamentos e desafios impostos no processo de trabalho das equipes de saúde da família. Este estudo trata - se de relato de experiência, de caráter descritivo e retrospectivo, associado à uma pesquisa bibliográfica para que trousse o embasamento teórico necessário para a descrição do relato de experiência vivenciado. No decorrer da pandemia, a Equipe de saúde da família exerceu importante papel e atuou na linha de prevenção e controle desta, sendo uma das maiores ferramentas de apoio. Na odontologia, a atuação da equipe de saúde bucal devido a fatores de risco inerentes à esta modalidade de ocupação, ficou limitada em seu exercício. O conhecimento de muitos dos profissionais da rede pública foi colocado em questão, assim como sua vivência, limitações e o medo de contrair a doença. Os profissionais da equipe de saúde, mostraram que o trabalho interprofissional e um bom relacionamento aumentou o incentivo e a responsabilidade de equipe.
This study aims to carry out an experience report demonstrating the perception of students of the dentistry course in their participation in the practice of primary health care (PHC), experienced in a pandemic scenario and based on the fight against confrontations and challenges imposed on the work process of family health teams. This study is an experience report, descriptive and retrospective, associated with bibliographical research to bring the necessary theoretical basis for the description of the lived experience report. During the pandemic, the Family Health Team played an important role and acted in the line of prevention and control of this, being one of the greatest support tools. In dentistry, the performance of the oral health team, due to risk factors inherent to this type of occupation, was limited in its exercise. The knowledge of many public health professionals was questioned, as well as their experience, limitations and fear of contracting the disease. Health team professionals showed that interprofessional work and a good relationship increased team incentive and responsibility.
Subject(s)
Humans , Primary Health Care , Students, Dental , Pandemics , COVID-19 , Working ConditionsABSTRACT
Background: The psychological approach can provide valuable insights into vaccination behaviour, especially in high-risk contexts. It offers new perspectives for effective interventions to improve vaccination behaviour. Aim: To investigate key factors influencing stress related to vaccination in emergency situations among healthcare professionals. Setting: Eastern region of Morocco. Methods: We conducted a descriptive and analytical cross-sectional study involving 221 healthcare professionals in the Eastern region of Morocco. A snowball sampling method was used to select the participants who were administered a questionnaire. Logistic regression analysis was performed with p < 0.05 being the level of statistical significance. Results: The participants had a median age of 25.5 years (3034.5) and were predominantly females (68.3%). Vaccination coverage stood at 84.6%, with a positive perception of 77.8%. The analysis of the Perceived Stress Scale (PSS) revealed that 51.6% (n = 114) of healthcare professionals experienced stress towards vaccination. Females were almost two times more susceptible to experiencing vaccination stress (p = 0.03). Furthermore, the analysis showed that vaccination profile (p = 0.02), accepting the vaccine for any reason other than its accessibility (p = 0.03) and having a previous coronavirus disease 2019 infection (p = 0.03), were significantly associated with stress. In contrast, healthcare professionals based at the university hospital had a significantly lower stress level (p = 0.01). Conclusion: Moroccan healthcare professionals exhibited high vaccine acceptance and positive perceptions, particularly among vaccinated individuals despite notable stress around immunisation. Contribution: These insights can guide governments and policymakers in developing strategies to enhance healthcare workers' awareness and understanding of vaccination.
Subject(s)
Perception , Awareness , Cross-Sectional Studies , Delivery of Health Care , Emergencies , Vaccination Coverage , COVID-19 Vaccines , COVID-19ABSTRACT
Introdução: O avanço da pandemia de COVID-19 acarretou alterações no sono da população. Os distúrbios do sono têm relação com as principais alterações de saúde mental e também possuem relação com os fatores psicossociais. Objetivo: Estimar a prevalência e fatores associados às alterações na qualidade do sono em usuários acompanhados na Atenção Primária à Saúde durante a pandemia de COVID-19. Métodos: Estudo do tipo transversal, com adultos (idade >18 anos) de ambos os gêneros, acompanhados por uma unidade de saúde. Foram levantadas as informações do prontuário eletrônico da unidade e, durante a visita domiciliar (entre agosto e setembro de 2021), os dados socioeconômicos, fatores de risco, sinais vitais, variáveis antropométricas, hábitos de vida, medicações em uso, uso dos serviços de saúde, internação e consultas no último ano. A qualidade de vida foi avaliada pelo questionário SF-36 e foi usado o Índice de Qualidade do sono Pittsburgh (PSQI). Resultados: A amostra foi formada predominantemente por mulheres (82,9%) com 60,5±11,7 anos de idade, da cor branca (70,7%), com companheiro (61%) e pertencentes à classe C (65,8%). 53,7% da amostra apresentou até duas comorbidades, 87,8% apresentavam sobrepeso/obesidade e 80% faziam uso de anti-hipertensivo. A prevalência de qualidade do sono ruim foi de 87,8% (IC95% 73,195,0). Os achados apontam para uma relação entre má qualidade do sono com consumo de álcool, presença de ≥3 comorbidades, níveis de PAS, uso de ansiolíticos, nível de escolaridade e uso de serviços de saúde durante a pandemia. Conclusões: A alta prevalência de qualidade do sono ruim na amostra estudada sugere que determinantes sociodemográficos, presença de comorbidades e hábitos de vida devem ser considerados para minimizar os efeitos das alterações do sono na pandemia.
Introduction: The advancement of the COVID-19 pandemic has resulted in changes in the sleep patterns of the population. Sleep disorders are related to major mental health changes and are also associated with psychosocial factors. Objective: To estimate the prevalence and factors associated with sleep quality changes among users attended in Primary Health Care during the COVID-19 pandemic. Methods: This was a cross-sectional study involving adults (age >18 years) of both genders who were being followed at a healthcare unit. Information was gathered from the unit's electronic medical records, and during home visits (between August and September 2021), socioeconomic data, risk factors, vital signs, anthropometric variables, lifestyle habits, current medications, healthcare service utilization, hospitalization, and consultations in the past year were collected. Quality of life was assessed using the SF-36 questionnaire, and the Pittsburgh Sleep Quality Index (PSQI) was used to evaluate sleep quality. Results: The sample consisted predominantly of women (82.9%) with an average age of 60.5±11.7 years, of white ethnicity (70.7%), with a partner (61%), and belonging to class C (65.8%). 53.7% of the sample had up to two comorbidities, 87.8% were overweight/obese, and 80% were using antihypertensive medication. The prevalence of poor sleep quality was 87.8% (95%CI 73.195.0). The findings indicate a relationship between poor sleep quality and alcohol consumption, the presence of ≥3 comorbidities, systolic blood pressure levels, use of anxiolytics, education level, and the use of healthcare services during the pandemic. Conclusions: The high prevalence of poor sleep quality in the study sample suggests that sociodemographic determinants, presence of comorbidities, and lifestyle habits should be considered to minimize the effects of sleep disturbances during the pandemic.
Introducción: El avance de la pandemia de COVID-19 ha ocasionado cambios en el sueño de la población. Los trastornos del sueño están relacionados con los principales cambios en la salud mental y también se asocian con factores psicosociales. Objetivo: Estimar la prevalencia y los factores asociados con alteraciones en la calidad del sueño en usuarios atendidos en la Atención Primaria de Salud durante la pandemia de COVID-19. Métodos: Estudio transversal con adultos (edad >18 años) de ambos géneros que son atendidos en una unidad de salud. Se recopilaron datos del historial clínico electrónico de la unidad y durante la visita domiciliaria (entre agosto y septiembre de 2021) se obtuvieron datos socioeconómicos, factores de riesgo, signos vitales, variables antropométricas, hábitos de vida, medicamentos utilizados, uso de servicios de salud, hospitalización y consultas en el último año. La calidad de vida se evaluó mediante el cuestionario SF-36 y se utilizó el Índice de Calidad del Sueño de Pittsburgh (PSQI). Resultados: La muestra estuvo compuesta predominantemente por mujeres (82,9%) con una edad de 60,5±11,7 años, de raza blanca (70,7%), con pareja (61%) y pertenecientes a la clase C (65,8%). El 53,7% de la muestra presentó hasta dos comorbilidades, el 87,8% tenían sobrepeso/obesidad y el 80% utilizaba medicación antihipertensiva. La prevalencia de mala calidad del sueño fue del 87,8% (IC95% 73,195,0). Los hallazgos señalan una relación entre la mala calidad del sueño y el consumo de alcohol, la presencia de ≥3 comorbilidades, los niveles de presión arterial sistólica (PAS), el uso de ansiolíticos, el nivel de escolaridad y el uso de servicios de salud durante la pandemia. Conclusiones: La alta prevalencia de mala calidad del sueño en la muestra estudiada sugiere que se deben considerar los determinantes sociodemográficos, la presencia de comorbilidades y los hábitos de vida para minimizar los efectos de los trastornos del sueño en la pandemia.
Subject(s)
Humans , Primary Health Care , Sleep Wake Disorders , Risk Factors , COVID-19ABSTRACT
Introdução: O conhecimento da magnitude em que a população implementa medidas de proteção emitidas pelas autoridades de saúde pública é essencial na prevenção da doença do novo coronavírus (COVID-19). A eficácia de medidas não farmacológicas de prevenção e das políticas públicas destinadas a reduzir o contágio pela COVID-19 depende de quão bem os indivíduos são informados sobre as consequências da infecção e as medidas que devem adotar para reduzir sua propagação. O entendimento, as atitudes e as práticas das pessoas em relação à COVID-19 e sua prevenção são basilares para a compreensão da dinâmica epidemiológica, demandando a realização de pesquisas sobre o cumprimento de medidas não farmacológicas de prevenção do contágio em diversos territórios. Para isso, em 2020, medidas não farmacológicas contra a COVID-19 foram divulgadas por fontes diversas, estatais e privadas, para a maior parte da população brasileira, com a finalidade de orientar comportamentos para conter a crise sanitária. As equipes da Estratégia Saúde da Família têm um papel fundamental neste processo de educação em saúde, pois compreendem elementos socioculturais das suas comunidades, alcançando-as tanto em capilaridade quanto em adequação local da informação técnico-científica. Este artigo abrange uma pesquisa de campo, parte de um projeto multicêntrico nacional. Objetivo: Avaliar se a população do território de uma unidade da Estratégia Saúde da Família da cidade de Condado-PE entende e aplica as informações que recebeu sobre medidas não farmacológicas de prevenção em suas práticas de proteção contra a COVID-19. Mais especificamente, a pesquisa visou determinar que informações foram recebidas pelos respondentes, quais as suas fontes, o grau de confiabilidade atribuído a estas, além da adesão deles às medidas não farmacológicas e sua relação com variáveis sociodemográficas. Métodos: O modelo do estudo foi observacional e descritivo, com abordagem quantitativa, a partir da coleta de dados primários com 70 usuários por entrevista presencial com questionário estruturado. Resultados: Os resultados mostraram que a população recebeu vasta informação sobre prevenção da doença. Conclusão: Com níveis variados de confiabilidade das fontes, atribuindo importância relevante às medidas de prevenção e adotou a maioria delas, com exceção do isolamento social total.
Introduction: Knowledge of the magnitude to which the population implements protective measures issued by public health authorities is essential in preventing coronavirus disease 2019 (COVID-19). The effectiveness of non-pharmacological prevention measures (NPM) and public policies aimed at reducing the spread of COVID-19 depends on how well individuals are informed about the consequences of the infection and the measures they must adopt to reduce its spread. The understanding, attitudes, and practices of people in relation to COVID-19 and its prevention are fundamental for understanding the epidemiological dynamics, demanding research on compliance with NPM to prevent contagion in different territories. To this end, in 2020, NPM against COVID-19 were released by various sources, state and private, for most of the Brazilian population, with the aim of guiding behaviors to contain the health crisis. The Family Health Strategy (FHS) teams play a key role in this health education process, as they comprise sociocultural elements of their communities, reaching them both in capillarity and in local adequacy of technical-scientific information. This article covers field research, part of a national multicenter project. Objective: To evaluate whether the population of the territory of an FHS unit in the city of Condado, Pernambuco, understands and applies the information it received about NPM prevention in their practices to protect against COVID-19. More specifically, the research aimed to determine what information was received by the respondents, what are their sources, the degree of reliability attributed to these, in addition to their adherence to the NPM and their relationship with sociodemographic variables. Methods: The study model was observational and descriptive, with a quantitative approach, based on the collection of primary data with 70 users through face-to-face interviews with a structured questionnaire. Results: The results showed that the population received extensive information on disease prevention. Conclusion: With varying levels of reliability of the sources, attributing relevant importance to prevention measures and adopted most of them, with the exception of total social isolation.
El conocimiento de la magnitud con la que la población implementa las medidas de protección emitidas por las autoridades de salud pública es fundamental en la prevención de la enfermedad por coronavirus 2019 (COVID-19). La efectividad de las medidas de prevención no farmacológicas (MFN) y de las políticas públicas dirigidas a reducir la propagación de la COVID-19 depende de qué tan bien se informe a las personas sobre las consecuencias de la infección y las medidas que deben adoptar para reducir su propagación. La comprensión, actitudes y prácticas de las personas con relación al COVID-19 y su prevención son fundamentales para comprender la dinámica epidemiológica, exigiendo investigaciones sobre el cumplimiento de las MNF para prevenir el contagio en diferentes territorios. Con ese fin, en 2020, MNF contra el COVID-19 fueron divulgados por diversas fuentes, estatales y privadas, para la mayoría de la población brasileña, con el objetivo de orientar comportamientos para contener la crisis sanitaria. Los equipos de la Estrategia de Salud de la Familia (ESF) juegan un papel fundamental en este proceso de educación en salud, ya que integran elementos socioculturales de sus comunidades, alcanzándolas tanto en la capilaridad como en la adecuación local de la información técnico-científica. Este artículo aborda una investigación de campo, parte de un proyecto multicéntrico nacional, con el objetivo de evaluar si la población del territorio de una unidad de la ESF en la ciudad de Condado-PE comprende y aplica la información recibida sobre la prevención de MNF en sus prácticas de protección contra el COVID -19. Más específicamente, la investigación tuvo como objetivo determinar qué información recibieron los encuestados, cuáles son sus fuentes, el grado de confiabilidad atribuido a estas, además de su adherencia al MNF y su relación con variables sociodemográficas. El modelo de estudio fue observacional y descriptivo, con enfoque cuantitativo, basado en la recolección de datos primarios con 70 usuarios a través de entrevistas cara a cara con un cuestionario estructurado. Los resultados mostraron que la población recibió amplia información sobre prevención de la enfermedad, con diversos niveles de confiabilidad de las fuentes, atribuyendo importancia relevante a las medidas de prevención y adoptando la mayoría de ellas, con excepción del aislamiento social total.
Subject(s)
Humans , National Health Strategies , Health Education , Health Communication , COVID-19 , Primary PreventionABSTRACT
Introdução: A Covid-19 é uma condição crônica que exige assistência à saúde longitudinal, característica fundante da Atenção Primária à Saúde (APS). As condições pós-Covid tornaram-se comuns no cotidiano da APS e, por esse motivo, é necessária uma base sólida de conhecimentos acerca da avaliação e do tratamento. Tal necessidade exige da Educação Permanente à Saúde contribuições para construção de saberes para o correto manejo de pacientes que apresentam tais quadros. Objetivo: Analisar a satisfação e a aprendizagem de profissionais da APS egressos do MOOC "Reabilitação do paciente com condições pós-Covid", a partir do modelo Kirkpatrick. Métodos: Estudo transversal, descritivo e analítico, composto de 612 profissionais da APS egressos do respectivo MOOC. A coleta de dados ocorreu por meio da situação de aprendizagem e de três questionários semiestruturados: um de perfil do aluno, um de expectativas do aluno e outro de avaliação do curso. A análise dos dados foi realizada pelo teste Wilcoxon, com nível de significância de 5%, no software RStudio versão 4.1.3. Todos os aspectos éticos foram atendidos. Resultados: Entre os profissionais egressos participantes, 68,5% eram do sexo feminino e 35,45% tinham entre 29 e 39 anos. Além disso, 92,3% informaram que não tinham funções na gestão. Quanto à análise de satisfação, 94,4% afirmaram que o conteúdo enfatiza pontos-chave e ideais relevantes. Quanto à aprendizagem, houve aumento significativo da mediana do pré-teste e do pós-teste, ao fim do curso (p<0,001), sugerindo que a aprendizagem foi significativa. Conclusões: O curso autoinstrucional contribuiu positivamente para a formação de profissionais da saúde que atuam na APS.
Introduction: Covid-19 is a chronic condition that requires longitudinal health care, a fundamental characteristic of Primary Health Care (PHC). Post-Covid conditions have become commonplace in the daily routine of PHC and, for this reason, a solid base of knowledge about assessment and treatment is needed. This need calls for Permanent Health Education to contribute to building knowledge for the correct management of patients with these conditions. Objective: To analyze the satisfaction and learning of PHC professionals who completed the MOOC "Rehabilitation of patients with post-COVID-19 conditions," based on the Kirkpatrick model. Methods: A cross-sectional, descriptive, and analytical study comprising 612 PHC professionals who graduated from the respective MOOC. Data was collected using the learning situation and three semi-structured questionnaires: one on the student's profile, one on the student's expectations, and another on course evaluation. Data analysis was carried out using the Wilcoxon test, with a significance level of 5%, in RStudio software version 4.1.3. All ethical aspects were met. Results: Among the participating professionals, 68.50% were female and 35.45% were aged between 29 and 39. In addition, 92.30% reported that they did not have a management role. As for the satisfaction analysis, 94.40% said that the content emphasized key points and relevant ideals. As for learning, there was a significant increase in the median of the pre-test and post-test at the end of the course (p-value <0.001), suggesting that learning was significant. Conclusions: The self-instructional course contributed positively to the training of health professionals working in PHC.
Introducción: El Covid-19 es una afección crónica que requiere una atención sanitaria longitudinal, característica fundamental de la Atención Primaria de Salud (APS). Las afecciones poscovídicas se han convertido en algo habitual en la APS diaria y, por este motivo, se necesita una base sólida de conocimientos sobre su evaluación y tratamiento. Esta necesidad exige que la Educación Permanente en Salud contribuya a construir el conocimiento para el correcto manejo de los pacientes con estas condiciones. Objetivo: Analizar la satisfacción y el aprendizaje de los profesionales de APS egresados del MOOC "Rehabilitación de pacientes con patología postcovídica-19", basado en el modelo de Kirkpatrick. Métodos: Estudio transversal, descriptivo y analítico, con 612 profesionales de APS egresados del respectivo MOOC. Los datos se recogieron utilizando la situación de aprendizaje y tres cuestionarios semiestructurados: uno sobre el perfil del alumno, otro sobre las expectativas del alumno y otro sobre la evaluación del curso. Los datos se analizaron mediante la prueba de Wilcoxon, con un nivel de significación del 5%, en el software RStudio versión 4.1.3. Se cumplieron todos los aspectos éticos. Resultados: Entre los profesionales participantes, el 68,50% eran mujeres y el 35,45% tenía entre 29 y 39 años. Además, el 92,30% declararon que no desempeñaban funciones directivas. En cuanto al análisis de la satisfacción, el 94,40% afirmó que el contenido hacía hincapié en los puntos clave y en los ideales pertinentes. En cuanto al aprendizaje, hubo un aumento significativo de la mediana del pretest y del postest al final del curso (p-valor <0,001), lo que sugiere que el aprendizaje fue significativo. Conclusiones: El curso autoinstruccional contribuyó positivamente a la formación de los profesionales de salud que trabajan en APS.
Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Education, Distance , Health Human Resource Training , Primary Health Care , Health Personnel , COVID-19/rehabilitationABSTRACT
Resumen Introducción: En distintos países, la epidemia de covid-19 se ha manifestado en el espacio geográfico como conglomerados de alta morbilidad o zonas calientes, y como conglomerados de puntos fríos de baja incidencia, los que han sido explicados a partir de variables sociales. Objetivo: Caracterizar los patrones la morbilidad de covid-19 en Costa Rica entre marzo del 2020 y mayo del 2022, y explicarlos desde los determinantes sociales de la salud en el contexto geográfico. Métodos: Se diseñó un estudio ecológico a nivel distrital, con datos sobre vacunación contra covid-19, reportes semanales sobre la velocidad de avance de la epidemia, el nivel de desarrollo, y otros datos demográficos. Se construyeron mapas temáticos, se identificaron y caracterizaron los patrones geoespaciales de la morbilidad explicados a partir de modelos de regresión lineal y geográficamente ponderada. Resultados: Se identificaron conglomerados de puntos calientes en la Gran Área Metropolitana y su entorno, y puntos fríos que flanquean esta zona de alta incidencia. El modelo de regresión lineal que incluyó el promedio de vacunas por persona, la velocidad en el reporte de casos semanal, el desarrollo social en sus dimensiones económica, educacional y sanitaria, así como la proporción de viviendas hacinadas y de personas nacidas en el exterior, explicó más del 70 % de las variaciones espaciales de la incidencia de casos (bruta y estandarizada por edad y sexo). El modelo geográficamente ponderado corrigió problemas de autocorrelación mejorando la capacidad explicativa a un 82 %. Conclusiones: La morbilidad durante la epidemia de covid-19, en Costa Rica, durante el período evaluado, se configuró mediante conglomerados espaciales de puntos calientes y fríos muy bien establecidos. Esta estructura se pudo explicar desde los determinantes sociales de la salud, comprobando que se generan efectos en la morbilidad, diferenciados territorialmente.
Abstract Introduction: The COVID-19 epidemic has manifested geographically as clusters of high morbidity (hot zones) and as cold spots of low incidence, which have been explained based on social variables. Objective: To characterize morbidity patterns due to COVID-19 in Costa Rica from March 2020 to May 2022 and to explain them through social determinants of health in the geographical context. Methods: An ecological study at the district level was designed with data on vaccination against COVID-19, weekly reports on speed of advance of the epidemic, development level, and other demographic data. Thematic maps were constructed, and spatial morbidity patterns were identified and characterized, which were explained using linear and geographically weighted regression models. Results: In the Greater Metropolitan Area and surrounding area, clusters of hot spots were identified, and cold spots flanked these high-incidence areas. The linear regression model, built from the variables: average number of vaccines per person, speed in weekly case reporting, social development in its economic, educational, and health dimensions, as well as the proportion of overcrowded homes and people born in the outside, explained more than 70 % of the spatial variations of the incidence of cases (crude and standardized by age and sex). The geographically weighted model corrected autocorrelation problems, improving the explanatory capacity to 82 %. Conclusions: morbidity during the COVID-19 epidemic until May 2020 was configured spatially through well-established clusters of hot and cold spots. This structure could be explained from the social determinants of health, proving that effects on morbidity are generated, differentiated territorially.
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , COVID-19/epidemiology , Costa Rica , Epidemiological Monitoring , Geographic MappingABSTRACT
Introducción. La aparición de la pandemia por SARS-CoV-2 generó grandes interrogantes sobre su comportamiento en diferentes escenarios. Objetivo. Describir el comportamiento clínico y epidemiológico de la COVID-19 en pacientes pediátricos residentes en una ciudad agroindustrial en tres períodos (2020 a 2022). Población y métodos. Estudio observacional, analítico de menores de 18 años con diagnóstico de COVID-19 en General Cabrera. Se evaluó sexo, edad, sintomatología, comorbilidades, internación y muerte. Se aplicó la prueba de chi-cuadrado para analizar la asociación entre sintomatología y período, y la prueba de Kruskal-Wallis para analizar diferencias en la duración de los síntomas por período. Nivel de confianza del 95 %. Resultados. En el período estudiado, se confirmaron 194 casos en menores de 18 años. Solo el 1 % requirió internación y no se registraron fallecimientos. El 51 % eran varones, con una mediana de edad 14 años para ambos sexos. El 68 % fue asintomático. Se detectaron comorbilidades asociadas en el 2 %. Conclusión. La infección por el SARS-CoV-2 tuvo baja presentación en pediatría, con comportamiento diferenciado según período.
Introduction. The onset of the SARS-CoV-2 pandemic raised questions about its behavior in different scenarios. Objective. To describe the clinical and epidemiological behavior of COVID-19 in pediatric patients living in an agricultural-industrial city across 3 periods (2020 to 2022). Population and methods. Observational, analytical study of children under 18 years diagnosed with COVID-19 in General Cabrera. Sex, age, symptoms, comorbidities, hospitalization, and death were analyzed. The χ² test was used to analyze the association between symptoms and period and the KruskalWallis test, to analyze differences in symptom duration per period. Confidence level: 95%. Results. In the study period, 194 cases in children under 18 years were confirmed. Only 1% required hospitalization; no deaths were recorded. Children's median age was 14 years; 51% were boys; 68% were asymptomatic; 2% had associated comorbidities. Conclusion. SARS-CoV-2 infection was low in pediatrics and showed a distinct behavior by period
Subject(s)
Humans , Male , Female , Infant , Child, Preschool , Child , Adolescent , COVID-19/epidemiology , Argentina/epidemiology , Time Factors , Comorbidity , Pandemics , Hospitalization/statistics & numerical dataABSTRACT
Introducción: La rehabilitación pulmonar es crucial para restaurar la independencia funcional y mejorar la calidad de vida de los pacientes tras el alta por COVID-19. En entornos extrahospitalarios, se consolida necesaria en el proceso de intervención en fibrosis pulmonar post-COVID-19. Objetivo: El objetivo de la revisión es describir el enfoque de la fibrosis pulmonar post-COVID-19 a través de la rehabilitación pulmonar extrahospitalaria. Material y métodos: Se realizó una revisión bibliográfica en las bases de datos académicas PubMed, Scopus y ScienceDirect; se usó lenguaje normalizado en inglés con términos DeCS/MeSH: "Pulmonary rehabilitation", "COVID-19", "Pulmonary Fibrosis" y "Ambulatory Care" publicados desde el 2020 al 2023; y se siguieron los rigurosos estándares establecidos por el Grading of Recommendations, Assessment, Development and Evaluations (GRADE) para valorar la calidad de la evidencia. Resultados: La búsqueda inicial arrojó un total de 661 estudios publicados desde ene-ro de 2020 a abril de 2024. Después de aplicar los criterios de inclusión y exclusión a los documentos, finalmente se incluyeron 11 artículos que daban respuesta al objetivo de la investigación. Conclusión: La infección pulmonar por COVID-19 puede dejar secuelas graves, como la fibrosis pulmonar, que afecta la función respiratoria y la calidad de vida. La rehabilitación pulmonar fuera del hospital ha resultado efectiva para mejorar la función pulmo-nar, reducir hospitalizaciones recurrentes y mejorar la calidad de vida en pacientes, más allá de aliviar los síntomas respiratorios.
Introduction: Pulmonary rehabilitation is crucial to restore functional independence and improve quality of life of patients after discharge from COVID-19. In extra-hospital settings, it is consolidated as necessary in the intervention process in post-COVID-19 pulmonary fibrosis. Objective: The objective of the review is to describe the approach to post-COVID-19 pulmonary fibrosis through out-of-hospital pulmonary rehabilitation. Material and methods: A bibliographic review was carried out in the academic data-bases PubMed, Scopus and ScienceDirect; standardized language in English was used with DeCS/MeSH terms: "Pulmonary rehabilitation", "COVID-19", "Pulmonary Fibrosis" and "Ambulatory Care" published from 2020 to 2023; and the rigorous standards es-tablished by the Grading of Recommendations, Assessment, Development and Evalua-tions (GRADE) to assess the quality of the evidence, was followed. Results: The initial search returned a total of 661 studies published from January 2020 to April 2024. After applying the inclusion and exclusion criteria to the documents, 11 articles were finally included that responded to the research objective. Conclusion: COVID-19 lung infection can leave serious sequelae, such as pulmonary fi-brosis, which affects respiratory function and quality of life. Out-of-hospital pulmonary rehabilitation has been effective in improving lung function, reducing recurrent hospi-talizations and improving quality of life in patients, beyond relieving respiratory symptoms.
Subject(s)
Humans , Pulmonary Fibrosis/rehabilitation , SARS-CoV-2 , COVID-19/complications , Lung , Quality of Life , Breathing Exercises , Review , Health Strategies , Ambulatory Care , Walk Test , GRADE Approach/methods , InfectionsABSTRACT
Introdução:A abordagem multiprofissional durante o período gestacional inclui ações de educação alimentar e nutricional, tendo em vista que o estado nutricional adequado e uma alimentação saudável são fundamentais para a eficácia do sistema imunológico e prevenção dedoenças crônicas e infecciosas. Objetivo:Relatar a experiência vivenciadapelas autorasno grupo de aconselhamento nutricional em um grupo de gestantes, assistidas em uma unidade da estratégia saúde da família no período de pandemia por SARS-CoV-2.Metodologia:Trata-se de um estudo descritivo, qualitativo, do tipo relato de experiência realizada a partir de uma ação de extensão universitária desenvolvida pelo projeto "Aconselhamento Nutricional de Gestantes em Tempos de Covid-19", durante o período de junho a dezembro de 2020. Resultados:Participaram do grupo 28 mulheres em diferentes períodos da gestação. Foram realizadas 24 sessões grupais, com duração de duas horas semanais. A experiência foi avaliada na perspectiva das estudantes de Nutrição, docentes e gestantes que participaram do projeto, especialmente, no que tange à oportunidade de reconhecer os limites, as potencialidades e os desafios do aconselhamento nutricional on-linede grupos. Conclusões:A interação com as gestantes possibilitou o diálogo com a equipe do projeto e direcionou a trajetória metodológica, tornando as gestantes agentes ativas da prática assistencial (AU).
Introduction: The multiprofessional approach during the gestational period includes actions of food and nutritional education, considering that the adequate nutritional status and a healthy diet are fundamental for the effectiveness of the immunesystem and prevention of chronic and infectious diseases.Objective: To report the experience lived by the authors in the nutritional counseling group in a pregnant woman group, assisted in a family health strategy unit during the SARS-CoV-2 pandemic.Methodology: It is a descriptive, qualitative study, the type report of experience carried out from an action of university extension developed by the project "Nutritional Advice to Pregnant Women in Times of Covid-19", during the period from June to December2020.Results: 28 women in different gestation periods participated in the group. There were 24 group sessions, lasting two hours per week. The experience was evaluated from the perspective of the students of Nutrition, teachers and pregnant women who participated in the project, especially regarding the opportunity to recognize the limits, potentials and challenges of online nutritional counseling groups.Conclusions: The interaction with pregnant women enabled dialogue with the project team and directed the methodological trajectory, making pregnant women active agents of the care practice (AU).
Introducción: El enfoque multiprofesional durante el período gestacional incluye acciones de educación alimentaria y nutricional, incluyendo teniendo en cuenta que el estado nutricional adecuado y una alimentación sana son fundamentales para la eficacia del sistema inmunológico y prevención de enfermedades crónicas e infecciosas. Objetivo: Relatar la experiencia vivida por las autoras en el grupo de asesoramiento nutricional en un grupo de gestantes, asistidas en una unidad de la estrategia salud familiar en el período de pandemia por SARS-CoV-2.Metodología: Se trata de un estudio descriptivo, cualitativo, del tipo relato de experiencia realizado a partir de una acción de extensión universitaria desarrollada por el proyecto "Asesoramiento Nutricional de Gestantes en Tiempos de Covid-19", durante el período de junio a diciembre de 2020. Resultados: Participaron del grupo 28 mujeres en diferentes períodos de gestación. Se realizaron 24 sesiones grupales, con una duración de dos horas semanales. La experiencia fue evaluada desde la perspectiva de las estudiantes de nutrición, docentes y gestantes que participaron en el proyecto, especialmente en lo que se refiere a la oportunidad de reconocer los límites, las potencialidades y los desafíos del asesoramiento nutricional on-line de grupos.Conclusiones: La interacción con las gestantes posibilitó el diálogo con el equipo del proyecto y orientó la trayectoria metodológica, haciendo a las gestantes agentes activos de la práctica asistencial (AU).
Subject(s)
Humans , Female , Pregnancy , Food and Nutrition Education , Pregnant Women , Information Technology , Telenutrition , COVID-19/complications , Epidemiology, Descriptive , Health Strategies , CommunicationABSTRACT
Introdução:Estudar vínculos interpessoais-familiares e sociais-depessoashomossexuais e bissexuais durante o isolamento da COVID-19é crucial para entender seu impacto na saúde mental, oferecendo suporte emocional, reduzindo solidão e aumentando resiliência de um grupo que já enfrenta altos níveis de discriminação e exclusão. Objetivo:Analisar as relações familiares e interpessoais de pessoas homossexuais e bissexuais durante o período de isolamento social na pandemia da COVID-19.Método:Estudo transversal e analítico realizado com 1411 homossexuais e bissexuais das cinco macrorregiões brasileiras, de junho a julho de 2020. Aplicou-se um questionário estruturado com questões sociodemográficas, um questionário a respeito das emoções vivenciadasna COVID-19, além do instrumento de Avalição da Tolerância nas Relações de Amizade. As variáveis foram apresentadas em valores absolutos e percentuais, sendo expostas em medidas descritivas e para comparar os grupos quanto as variáveis de tolerância de amizade no relacionamento familiar e nível geral de tolerância, utilizou-se o teste de qui-quadrado. Valores de p<0,05 foram considerados estatisticamente significativos. Resultados:Não houve diferença estatística significativa entre os gruposno que tange às relações de amizade; a tolerância no ambiente familiar foi satisfatória, ambos receberam ajuda dos amigos para superar as tensões relacionadasàpandemia; e os indivíduos dos dois grupos acreditam ter ocorrido mudança nas relações de amizade durante o período pandêmico. O avanço da idade (p=0,031) contribui para o aumento da tolerância nas relações de amizade (p<0,001). Mas ser bissexual (p=0,021), apresentar nível superior (p=0,01), possuir faixa de renda entre 2 e 4 saláriosmínimos (p<0,001) e ter sofrido mudança nas relações de amizade desde o início da pandemia (p= 0,001) contribuem para menores níveis de tolerância. Conclusão:Embora haja diversos fatores que interferem nas relações interpessoais deste grupo, elas foram imprescindíveis para a superação das adversidades enfrentadas pela pandemia (AU).
Introduction: Studying interpersonal bondsboth familial and socialamong homosexual and bisexual individuals during the COVID-19 isolation is crucial for understanding its impact on mental health, providing emotional support, reducing loneliness, and increasing the resilience of a group that already faces high levels of discrimination and exclusion.Objective: To analyze the family and interpersonal relationships of homosexual and bisexual individuals during the social isolation period of the COVID-19 pandemic. Method: A cross-sectional and analytical study was conducted with 1411 homosexual and bisexual individuals from the five macroregions of Brazil, from June to July 2020.A structured questionnaire with sociodemographic questions, a questionnaire about emotions experienced during COVID-19, and the FriendshipTolerance Assessment instrument were applied. The variables were presented in absolute values and percentages, described descriptively. The chi-square test was used to compare the groups regarding friendship tolerance variables in family relationships andthe overall tolerance level. Values of p<0.05 were considered statistically significant. Results: There was no statistically significant difference between the groups regarding friendship relationships; tolerance in the family environment was satisfactory; both groups received help from friends to overcome pandemic-related tensions; and individuals from both groups believe there has been a change in friendship relationships during the pandemic period. Advancing age (p=0.031) contributes to increased tolerance in friendship relationships (p<0.001). However, being bisexual (p=0.021), having a higher education level (p=0.01), having an income between 2 and 4 minimum wages (p<0.001), and experiencing a change in friendship relationships since the beginning of the pandemic (p=0.001) contribute to lower levels of tolerance. Conclusion: Although various factors influence interpersonal relationships in this group, these bonds were essential for overcoming the adversities faced during the pandemic (AU).
Introducción:Estudiar los vínculos interpersonales de personas homosexuales y bisexuales durante el aislamiento por COVID-19 es crucial para entender su impacto en la salud mental, ofreciendo apoyo emocional, reduciendo la soledad y aumentando la resiliencia.Objetivo:Analizar las relaciones familiares e interpersonales de personas homosexuales y bisexuales durante elperíodo de aislamiento social en la pandemia deCOVID-19. Método:Estudio transversal y analítico con 1411 homosexuales y bisexuales de las cinco macroregiones de Brasil, de junio a julio de 2020. Se aplicó un cuestionario estructurado con preguntas sociodemográficas, sobre las emociones vividas durante la COVID-19 y el instrumento de Evaluación de la Tolerancia en las Relaciones de Amistad. Las variables se presentaron de manera descriptiva, y para comparar las variables de tolerancia en las relaciones familiares y el nivel general de tolerancia, se utilizó la prueba de chi-cuadrado.Se consideraron estadísticamente significativos los valores de p<0.05.Resultados:No hubo diferencia estadísticamente significativa entre los grupos en cuanto a las relaciones de amistad; la tolerancia en el entorno familiar fue satisfactoria. Ambos grupos recibieron ayuda de amigos para superar las tensiones relacionadas con la pandemia, y los individuos de ambos grupos consideran que ha habido un cambio en las relaciones de amistad durante el período pandémico. El avance de la edad (p=0,031) contribuye al aumento de la tolerancia en las relaciones de amistad (p<0,001). Sin embargo, ser bisexual (p=0,021), tener un nivel educativo superior (p=0,01), contar con un ingreso entre2 y 4 salarios mínimos (p<0,001) y haber experimentado un cambio en las relaciones de amistad desde el inicio de la pandemia (p=0,001) contribuyen a niveles más bajos de tolerancia. Conclusión:Aunque existen diversos factores que influyen en las relaciones interpersonales de este grupo, estas fueron fundamentales para superar las adversidades enfrentadas durante la pandemia (AU).
Subject(s)
Humans , Male , Female , Adult , Social Discrimination , Sexual and Gender Minorities , Health Inequality Monitoring , COVID-19/complications , Cross-Sectional Studies/methods , Surveys and Questionnaires , Analysis of VarianceABSTRACT
La Revista Informativa Estación Vigilancia Genómica N° 8 presenta los avances del proyecto "Fortalecimiento de la toma de decisiones en el control de la pandemia COVID-19 mediante la vigilancia genómica". Contiene: Avances y perspectivas de la vigilancia genómica integral de la RAM en Bolivia. "Voces de la Pandemia": Colombia lidera una historia de ciencia y resiliencia frente a la COVID-19. Ecuador: INSPI rinde homenaje al Dr. Leopoldo Izquieta Pérez y refuerza su impacto en la salud pública.
Subject(s)
Genomics , COVID-19 , EpidemiologyABSTRACT
INTRODUCCIÓN: Administración de la vacuna contra la enfermedad por coronavirus 2019-nCoV y sus posibles efectos en la aceptación de esta en los trabajadores de salud. OBJETIVO: Evaluar la actitud del personal de salud del Hospital Goyeneche III Arequipa Perú con relación a la vacuna contra la enfermedad por coronavirus 2019-nCoV e identificarlos para reforzar creencias favorables sobre la vacuna. MA-TERIALES Y MÉTODOS: Estudio observacional descriptivo correlacional de corte transversal, con una población de 916 profesionales de salud de los que fueron se-leccionados 120 profesionales de salud, el 100% de los encuestados (n:120) fueron vacunados contra la enfermedad por coronavirus 2019-nCoV en el Hospital III Go-yeneche. Se evaluó la actitud del personal de salud frente a la vacuna utilizando las encuestas en físico distribuida en 2 semanas mediante muestreo aleatorio simple. Los datos fueron analizados mediante SPSS. RESULTADOS: Los médicos cons-tituyeron el 39,2% de los participantes en el estudio, mientras que la mayoría de los trabajadores vacunados con cuatro dosis representaron el 45,8%. Se observó una buena aceptación de la vacuna contra el coronavirus 2019-nCoV, destacando el acuerdo en las dimensiones conductual, cognitiva y afectiva de la actitud. CONCLU-SION: Se notó que los trabajadores de la institución muestran una buena aceptación de la vacuna contra el coronavirus 2019-nCoV, y el personal de salud fue motivado a vacunarse por otros colegas de la misma institución. Durante la pandemia, las autori-dades gubernamentales debieron implementar medidas para fomentar la aceptación de la vacuna, utilizando canales oficiales para tal propósito.
INTRODUCTION: Administration of the vaccine against coronavirus disease 2019-nCoV and its possible effects on its acceptance in health workers. OBJECTIVE: To evaluate the attitude of health personnel at the Goyeneche III Hospital Arequipa Peru in relation to the vaccine against coronavirus disease 2019-nCoV and identify them to reinforce favorable beliefs about the vacci-ne. MATERIALS AND METHODS: Cross-sectional descriptive correlational observational study, with a population of 916 health professionals from which 120 health professionals were selec-ted, 100% of the respondents (n:120) were vaccinated against coronavirus disease 2019- nCoV at Hospital III Goyeneche. The attitude of health personnel towards the vaccine was evaluated using physical surveys distributed over 2 weeks through simple random sampling. The data were analyzed using SPSS. RESULTS: Doctors represented 39.2% of the study, the majority of workers vaccinated with 4 doses represented 45.8%. There was a good acceptance of the vaccine against coronavirus disease 2019-nCoV in terms of agreeing in the behavioral, cogni-tive, as well as affective dimension of the attitude.: CONCLUSION: Workers at the institution have shown a positive acceptance of the 2019-nCoV coronavirus disease vaccine, encouraging healthcare staff to get vaccinated themselves. During the pandemic, government authorities had to implement measures to enhance vaccine acceptance using official channels.
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Young Adult , Attitude of Health Personnel , Patient Acceptance of Health Care , Health Knowledge, Attitudes, Practice , Health Personnel , COVID-19 Vaccines , COVID-19 , PeruABSTRACT
La Revista Informativa N° 7 presenta los avances del proyecto "Fortalecimiento de la toma de decisiones en el control de la pandemia COVID-19 mediante la vigilancia genómica". En su contenido destaca: Bolivia impulsará la vigilancia con un enfoque "Una Salud" para un monitoreo integral de patógenos; Colombia, sede del Curso Internacional de Epidemiología Genómica y Genómica en acción: Perú avanza en la lucha contra las amenazas globales a la salud pública.
Subject(s)
Genomics , COVID-19 , EpidemiologyABSTRACT
Introducción. En la adolescencia, se comienzan a tomar decisiones autónomas sobre la salud. En la vacunación intervienen dimensiones contextuales, grupales y relativas a cada vacuna. Se busca conocer el proceso de información, confianza y decisión de vacunarse contra COVID-19 en adolescentes usuarios de un centro de salud en Buenos Aires. Objetivos. Identificar ámbitos y canales a través de los cuales los adolescentes accedieron a información sobre la vacuna contra COVID-19 en un centro de salud de Buenos Aires. Describir sus opiniones respecto a los distintos discursos sobre vacunación. Describir su participación en la vacunación contra COVID-19. Identificar barreras y facilitadores respecto del acceso a la vacunación contra COVID-19 en esta población. Población y métodos. Investigación cualitativa. Se hicieron entrevistas semiestructuradas a adolescentes usuarios del efector. La muestra fue heterogénea; su tamaño se definió por saturación teórica. Se realizó un análisis temático de los datos. Resultados. Se realizaron 14 entrevistas. Los entrevistados recibieron información sobre la vacuna contra COVID-19 de sus familias, la televisión y las redes sociales. Todos recibieron tanto publicidad oficial como discursos reticentes a la vacunación. Analizaron la información recibida y formaron opinión autónoma. Su decisión sobre vacunarse no siempre fue respetada. La desconfianza, la baja percepción del riesgo, el temor a las inyecciones, las barreras administrativas y geográficas fueron motivos de no vacunación. Conclusiones. Se requieren estrategias de comunicación destinadas a adolescentes que promuevan su participación en el acceso a la vacunación.
Introduction. During adolescence, individuals start to make autonomous decisions about their health. Vaccination involves contextual, group, and vaccine-specific dimensions. We sought to know the information, trust, and decision to receive the COVID-19 vaccine among adolescents who attended a healthcare center in Buenos Aires. Objectives. To identify settings and channels through which adolescents accessed information about the COVID-19 vaccine at a healthcare center in Buenos Aires. To describe their opinions about the different statements on vaccination. To describe their participation in COVID-19 vaccination. To identify barriers and facilitators to COVID-19 vaccination in this population. Population and methods. Qualitative study. Semi-structured interviews with adolescents who attended this healthcare facility. The sample was heterogeneous; the sample size was estimated by theoretical saturation. A thematic analysis of data was done. Results. A total of 14 interviews were conducted. Interviewees obtained information about the COVID-19 vaccine from their families, TV, and social media. All received information from both official campaigns and anti-vaccine communications. They analyzed the information they received and formed their own opinion. Their decision about the vaccine was not always respected. Hesitancy, a low perception of risk, fear of needles, administrative and geographic barriers were reasons for not receiving the vaccine. Conclusions. Communication strategies targeted at adolescents are required that encourage their involvement in access to vaccination.
Subject(s)
Humans , Male , Female , Adolescent , Trust , Qualitative Research , COVID-19 Vaccines/administration & dosage , Argentina , Patient Acceptance of Health Care/psychology , Patient Acceptance of Health Care/statistics & numerical data , Interviews as Topic , Vaccination/psychology , Vaccination/statistics & numerical data , Decision Making , COVID-19/prevention & control , Vaccination Hesitancy/psychology , Vaccination Hesitancy/statistics & numerical data , Health Facilities , Health Services AccessibilityABSTRACT
La 6ta edición de la revista informativa del proyecto "Fortalecimiento de la toma de decisiones en el control de la pandemia COVID-19 mediante la vigilancia genómica". Reflexiona sobre cuán útil es la vigilancia genómica para el cuidado de la salud pública en la región andina. Entre los avances del proyecto, se resalta: Implementación de la Red Nacional de Vigilancia Genómica en Bolivia: El objetivo principal del INLASA. INSPI de Ecuador: Fortaleciendo la vigilancia y respuesta ante futuras pandemias y el dengue bajo la lupa genómica del INS Perú.
Subject(s)
Genomics , COVID-19 , EpidemiologyABSTRACT
Introduction. Data on the prevalence of fungal coinfections/superinfections in patients with COVID-19 are limited. Objective. To describe the prevalence of fungal coinfections/superinfections in patients with COVID-19, as well as risk factors and demographic, clinical, and microbiological characteristics. Materials and methods. We included patients with a confirmed COVID-19 diagnosis and a confirmed fungal infection hospitalized in the ICU from March 2020 to December 2021. We collected data on age, sex, comorbidities, hospital length of stay (days), laboratory (ferritin) and microbiological results, treatment for COVID-19, antifungal therapy, and outcomes obtained from the clinical records. Results. Only 11 out of 740 patients met the inclusion criteria. The coinfection rate was 0.3% and the superinfection was 1.2%. The most affected population was male adults. The coinfections/superinfections diagnosed were candiduria and candidemia, caused by Candida albicans, C. tropicalis, C. glabrata, C. lusitaniae, and Kluyveromyces marxianus (C. kefyr). In addition, tracheobronchitis due to Aspergillus fumigatus was found. The most used antifungals were fluconazole and caspofungin. The lethality in patients with fungal coinfections was 50% and superinfections, 22%. The length of hospital stay was 11-65 days. Eight patients required mechanical ventilation and six received corticosteroids. The main comorbidity was diabetes mellitus (81.8%). Conclusions. The rate of fungal coinfections/superinfections in COVID-19 patients was low, but the lethality found urges for routine fungal screening in patients with severe COVID-19 to timely detect fungal infections that may further compromise the patient's life.
Introducción. Los datos sobre la prevalencia de coinfecciones o sobreinfecciones fúngicas en pacientes con COVID-19 son limitados. Objetivo. Describir la prevalencia de coinfecciones o sobreinfecciones fúngicas en pacientes con COVID-19, así como los factores de riesgo y las características demográficas, clínicas y microbiológicas. Materiales y métodos. Se incluyeron pacientes con diagnóstico confirmado de COVID-19, hospitalizados en la unidad de cuidados intensivos y con infección fúngica confirmada entre marzo del 2020 y diciembre del 2021. Del expediente clínico se obtuvieron datos sobre edad, sexo, comorbilidades, días de estancia hospitalaria, resultados de laboratorio (ferritina) y microbiológicos, tratamiento contra COVID-19, terapia antifúngica y desenlace. Resultados. Once de 740 pacientes cumplieron con los criterios de inclusión. La tasa de coinfección fue del 0,3 % y la de sobreinfección fue del 1,2 %. La población más afectada fue la de hombres adultos. Las coinfecciones o sobreinfecciones diagnosticadas fueron candiduria y candidemia, causadas por Candida albicans, C. tropicalis, C. glabrata, C. lusitaniae y Kluyveromyces marxianus (C. kefyr). Además, se encontró una traqueobronquitis por Aspergillus fumigatus. Los antifúngicos más administrados fueron fluconazol y caspofungina. La letalidad en pacientes con coinfecciones fue del 50 % y con sobreinfecciones fúngicas, del 22 %. El tiempo de estancia intrahospitalaria fue de 11 a 65 días. Ocho de los pacientes requirieron asistencia respiratoria mecánica y seis recibieron corticoides. La principal comorbilidad fue diabetes mellitus (81,8 %). Conclusiones. La tasa de coinfecciones o sobreinfecciones por hongos en pacientes con COVID-19 fue baja, pero la letalidad de estas requiere, con urgencia, la realización de pruebas de rutina para detectar hongos en pacientes con COVID-19 grave para diagnosticar oportunamente infecciones fúngicas que puedan comprometer aún más la vida del paciente.
Subject(s)
Humans , COVID-19 , Mexico , Mycoses , Aspergillosis , CandidemiaABSTRACT
Introduction. Due to the cross-reactivity between SARS-CoV-2 and common human coronaviruses, previous infections with these viruses could contribute to serological or cellular cross-protection against severe COVID-19. However, protective immunity may not develop, or pre-existing immunity could increase COVID-19 severity. Objective. To determine the seroprevalence of IgG antibodies against HCoV-NL63 and HCoV-HKU1 and correlate previous exposure with COVID-19 signs in patients from Villavicencio. Materials and methods. A cross-sectional retrospective study was conducted. ELISA technique was used to search for IgG antibodies against HCoV-NL3 and HCoV-HKU1 in patients with positive RT-qPCR results for SARS-CoV-2. Patients were grouped according to COVID-19 clinical characteristics in four groups: group 1: asymptomatic (n = 23); group 2: hospitalized (n = 24); group 3: intensive care units (n = 24), and group 4: dead (n = 22). Results. The overall seroprevalence of IgG antibodies against HCoV was 74.2% (n = 69; 95% CI: 65.3-83.1), with 66.7% of HCoV-NL63 (n = 62; 95% CI: 57,1-76,2), and 25.8% of HCoV-HKU1 (n = 24; 95% CI: 16,9-34,7). Based on crosstab analysis, prior exposure to HCoV-NL63 was associated with protection against severe COVID-19 (p = 0.042; adjusted OR = 0.159; 95% CI: 0.027-0.938), and previous coinfection of HCoV-NL63 and HCoV-HKU1 was considered a positive association to severe COVID-19 (p = 0.048; adjusted OR = 16.704; 95% CI: 1.020 - 273.670). Conclusion. To our knowledge, this is the first study addressing seroprevalence of HCoV IgG antibodies in Colombia and Latin America. Previous exposure to HCoV-NL63 could protect against severe COVID-19, whereas patients with underlying HCoV-NL63 and HCoV-HKU1 coinfection could be hospitalized with severe signs of COVID-19.
Introducción. Debido a la reactividad cruzada entre SARS-CoV-2 y los coronavirus humanos comunes, las infecciones previas con estos virus podrían contribuir a la protección cruzada serológica o celular contra la COVID-19 grave. Sin embargo, la inmunidad protectora puede no desarrollarse o la inmunidad preexistente podría generar COVID-19 grave. Objetivo. Determinar la seroprevalencia de anticuerpos IgG frente a HCoV-NL63 y HCoV-HKU1, y correlacionar su previa exposición con los signos de COVID-19 en pacientes de Villavicencio. Materiales y métodos. Se realizó un estudio retrospectivo observacional analítico y transversal. Se utilizó la técnica ELISA para buscar anticuerpos IgG contra HCoV-NL3 y HCoV-HKU1 en pacientes con resultado positivo de RT-qPCR para SARS-CoV-2. Los pacientes se agruparon según los signos de COVID-19 en cuatro grupos: grupo 1: asintomáticos (n = 23); grupo 2: hospitalizados (n = 24); grupo 3: unidad de cuidados intensivos (n = 24), y grupo 4: fallecidos (n = 22). Resultados. La seroprevalencia general de IgG anti-HCoV fue de 74.2 % (n = 69; IC95%: 65,3-83,1), con 66,7 % de HCoV-NL63 (n = 62; IC95%: 57,1-76,2) y 25,8 % de HCoV-HKU1 (n = 24; [IC95%:16,9-34,7). Según el análisis de las tablas de contingencia, la exposición previa a HCoV-NL63 se asoció con protección de una COVID-19 grave (p = 0,042; OR ajustado = 0,159; IC95%: 0,027-0,938) y la previa coinfección de HCoV-NL63 y HCoV-HKU1 se asoció con padecimiento de signos clínicos graves por COVID-19 (p = 0,048; OR ajustado = 16,704; IC95%: 1,020- 73,670). Conclusión. Según la literatura revisada hasta la fecha, este es el primer estudio sobre la seroprevalencia de anticuerpos IgG de HCoV en Colombia y Latinoamérica. La exposición previa a HCoV-NL63 podría proteger contra la COVID-19 grave, mientras que los pacientes con coinfección subyacente de HCoV-NL63 y HCoV-HKU1 podrían resultar hospitalizados con signos graves de COVID-19.
Subject(s)
Humans , Coronavirus NL63, Human , SARS-CoV-2 , COVID-19 , Immunoassay , BetacoronavirusABSTRACT
RESUMEN El propósito del estudio fue describir las características del síndrome inflamatorio multisistémico asociado a COVID-19 (SIM-C) en los primeros tres años de pandemia en niños de un hospital pediátrico del Perú. Se realizó un estudio observacional, descriptivo con datos de 73 pacientes y se describieron las características clínicas, laboratoriales, tratamiento y complicaciones según la ola de la pandemia y si tuvieron shock. La mediana de edad fue 6 años, las manifestaciones gastrointestinales y mucocutáneas fueron frecuentes en las tres olas. El fenotipo similar a enfermedad de Kawasaki se presentó en 34 (46,6%) pacientes y 21 (28,8%) pacientes desarrollaron shock. El tratamiento más usado fue la inmunoglobulina (95,9%), ácido acetil salicílico (94,5%) y corticoide (86,3%). Cinco (7%) pacientes tuvieron aneurisma coronario y 17 (23,3%) ingresaron a la unidad de cuidados intensivos (UCI). Los pacientes con shock tuvieron mayor alteración laboratorial y necesidad de ventilación mecánica. En conclusión, el SIM-C ha disminuido en los primeros tres años de pandemia posiblemente por la vacunación de COVID-19 en niños.
ABSTRACT This study aimed to describe the characteristics of multisystemic inflammatory syndrome associated with COVID-19 (MIS-C) in the first three years of the pandemic in children in a pediatric hospital in Peru. We conducted an observational, descriptive study with data from 73 patients and described the clinical and laboratory characteristics, treatment and complications according to the wave of the pandemic and whether they had shock. The median age was 6 years, gastrointestinal and mucocutaneous manifestations were frequent in the three waves. Kawasaki disease-like phenotype was present in 34 (46.6%) patients and 21 (28.8%) patients developed shock. The most commonly used treatment was immunoglobulin (95.9%), followed by acetylsalicylic acid (94.5%) and corticosteroid (86.3%). Five (7%) patients had coronary aneurysm and 17 (23.3%) were admitted to the intensive care unit (ICU). Patients with shock had greater laboratorial alteration and need for mechanical ventilation. In conclusion, MIS-C has decreased in the first three years of the pandemic, possibly due to COVID-19 vaccination in children.