RESUMEN
ABSTRACT Background: Severe pneumonia is the most common cause of intensive care unit (ICU) admission and death due to novel coronavirus (SARS-CoV-2) respiratory disease (COVID-19). Due to its rapid outbreak, units for the evaluation of febrile patients in the pre-hospital setting were created. Objective: The objective of the study was to develop a sensitive and simple tool to assess the risk of pneumonia in COVID-19 patients and thus select which patients would require a chest imaging study. Materials and Methods: We conducted a cross-sectional study in a cohort of individuals with suspected COVID-19 evaluated in a public academic healthcare center in Buenos Aires city. All adult patients with positive RT-PCR assay for SARS-COV2 between April 24 and May 19 of 2020 were included in the study. Pneumonia was defined as the presence of compatible signs and symptoms with imaging confirmation. Univariate and multivariate logistic regression was performed. A risk indicator score was developed. Results: One hundred and forty-eight patients were included, 71 (48%) received the diagnosis of pneumonia. The final clinical model included four variables: age ≥ 40 years, cough, absence of sore throat, and respiratory rate ≥ 22. To create the score, we assigned values to the variables according to their ORs: 2 points for respiratory rate ≥ 22 and 1 point to the other variables. The AUC of the ROC curve was 0.80 (CI 95% 0.73-0.86). A cutoff value of 2 showed a sensitivity of 95.7% and a specificity of 43.24%. Conclusion: This sensible score may improve the risk stratification of COVID-19 patients in the pre-hospital setting. (REV INVEST CLIN. 2021;73(1):52-8)
Asunto(s)
Humanos , Masculino , Femenino , Adolescente , Adulto , Persona de Mediana Edad , Adulto Joven , Neumonía Viral/diagnóstico , Fiebre/diagnóstico , COVID-19/complicaciones , Unidades de Cuidados Intensivos , Argentina , Neumonía Viral/etiología , Índice de Severidad de la Enfermedad , Riesgo , Estudios Transversales , Estudios Prospectivos , Estudios de Cohortes , Sensibilidad y Especificidad , Reacción en Cadena de la Polimerasa de Transcriptasa Inversa , Fiebre/virología , COVID-19/diagnósticoRESUMEN
Se estudiaron diferentes características de la anemia ferropénica en lactantes de 12 a 23 meses de edad en un estudio prospectivo realizado en una comunidad urbana de San José de Costa Rica. La incidencia de anemia en toda población estudiada fue de 63.5%. Excluyendo los niños factores de riesgo para deficiencia de hierro, sólo el 40% tenían Hb normal, y sólo el 13% Hb y Fe normales. El antecendente de Fe no modificó el nivel de Hb de la población, lo que sugiere un control inadecuado de su ingesta. La ingesta de leche materna mejoró el status de Fe de los lactantes. Después de tres meses de tratamiento, la Hb se incrementó significativamente en todos los grupos, aún en los niños con Hb "normal", para una Hb promedio final de 13.2g/dl(8.1mmol/l), lo que demuestra la deficiencia real de Fe de los lactantes estudiados. La respuesta fue más efectiva con Fe oral que con Fe intramuscular