ABSTRACT
Background and aim: Patients with Chronic obstructive pulmonary disease (COPD) and COVID-19 have increased risk of hospitalization and Instensive Care Unit (ICU) admission (1). Aims and objectives: To indentify risk factors for intrahospital mortality in COPD patients with COVID-19 admitted to Spanish ICUs. Method(s): Demographic and clinical data during ICU admission were recorded using REDCap on all patients hospitalized for COVID-19 in 70 Spanish ICUs (2). We described the baseline clinical characteristics of COPD compared to other chronic respiratory disease (CRD) and to the overall population. We identified the risk factors for intrahospital mortality of COPD patients receiving invasive mechanical ventilation (IMV) and for those COPD receiving noninvasive respiratory support (NIRS). Result(s): Two hundred and sixty-eight ICU patients (5%) had COPD out of 5196 included. No differences were found between COPD, CRD or the overall population in the rates of IMV (76-78%) vs NIRS (22-24%). COPD intrahospital mortality was much higher in the IMV subgroup (58%). Independent risk factors for intrahospital mortality in the COPD+IMV or COPD+NIRS were: age and chronic Kidney disease or hypertension, respectively. Previous NIRS in COPD+IMV group was protective for intrahospital mortality (Figure). Conclusion(s): New strategies are needed to reduce the high intrahospital and 90-days mortality of COPD COVID-19 patients admitted to ICU.
ABSTRACT
Background: The advance of the pandemic in the large cities of the world with great virulence and the apparent heterogeneous distribution by factors of vulnerability, led us to propose this work. The objective of this study was to relate COVID-19 infection rates to the social vulnerability of the city of Madrid by district, in two different episodes, spring 2020 and summer 2020.
ABSTRACT
Background: The advance of the pandemic in the large cities of the world with great virulence and the apparent heterogeneous distribution by factors of vulnerability, led us to propose this work. The objective of this study was to relate COVID-19 infection rates to the social vulnerability of the city of Madrid by district, in two different episodes, spring 2020 and summer 2020. Methods: Analytical cross-sectional study. Taking sociodemographic data of the entire population of the city of Madrid between the months of April and October 2020, together with the cumulative incidence rates of COVID-19, a linear regression analysis, correlation and factor analysis was carried out, relating the cumulative incidence rate of COVID-19 and the vulnerability indicator of the districts of the city of Madrid. Results: The results showed important differences between the two episodes of the pandemic: on one hand, the first had more relationship with health factors, while in the second, a relationship appeared with the groups of greater social vulnerability, territorially located in the South-East of the City and related in this case to social factors rather than health. Thus we see that the TIA x 100,000 in the first episode in Chamberi and Usera-two extreme districts in vulnerability-were 896 and 843 cases respectively, while in the second they were 3,708 and 6,258 cases. Conclusions: The territorial differences in the city become evident with the arrival of a generalised, universal event such as COVID-19, where vulnerability increases for everyone, with greater repercussions in those territories where it already had an impact.
ABSTRACT
Background: A special survey carried out between April and September 2021 in Italy involving 600 respondents forms the basis of the present contribution. This survey focused on mapping and acquiring a deeper understanding of the possibilities of promoting a long-term vision for the development of future care for people in the pre-terminal and terminal stages of the disease and for the dying. Conclusion: Similar surveys may provide relevant and inspiring stimuli for additional and novel specific surveys, studies and analyses, as well as scientific and professional discourses regarding the importance of establishing inspiring long-term visions for the development of future care for the dying.
ABSTRACT
OBJECTIVE: The advance of the pandemic in the large cities of the world with great virulence and the apparent heterogeneous distribution by factors of vulnerability, led us to propose this work. The objective of this study was to relate COVID-19 infection rates to the social vulnerability of the city of Madrid by district, in two different episodes, spring 2020 and summer 2020. METHODS: Analytical cross-sectional study. Taking sociodemographic data of the entire population of the city of Madrid between the months of April and October 2020, together with the cumulative incidence rates of COVID-19, a linear regression analysis, correlation and factor analysis was carried out, relating the cumulative incidence rate of COVID-19 and the vulnerability indicator of the districts of the city of Madrid. RESULTS: The results showed important differences between the two episodes of the pandemic: on one hand, the first had more relationship with health factors, while in the second, a relationship appeared with the groups of greater social vulnerability, territorially located in the South-East of the City and related in this case to social factors rather than health. Thus we see that the TIA x 100,000 in the first episode in Chamberi and Usera -two extreme districts in vulnerability- were 896 and 843 cases respectively, while in the second they were 3,708 and 6,258 cases. CONCLUSIONS: The territorial differences in the city become evident with the arrival of a generalised, universal event such as COVID-19, where vulnerability increases for everyone, with greater repercussions in those territories where it already had an impact.
ABSTRACT
The French-speaking Respiratory Medicine Society (SPLF) proposes a guide for the management of possible respiratory sequelae in patients who have presented with SARS-CoV-2 pneumonia (COVID-19). The proposals are based on known data from previous epidemics, preliminary published data on post COVID-19 follow-up and on expert opinion. The proposals were developed by a group of experts and then submitted, using the Delphi method, to a panel of 22 pulmonologists. Seventeen proposals were validated ranging from additional examinations after the minimum assessment proposed in the SPLF monitoring guide, to inhaled or systemic corticosteroid therapy and antifibrotic agents. These proposals may evolve over time as knowledge accumulates. This guide emphasizes the importance of multidisciplinary discussion.
Subject(s)
COVID-19/complications , Cough/therapy , Dyspnea/therapy , Lung/diagnostic imaging , Administration, Inhalation , Bronchial Hyperreactivity/diagnosis , Bronchial Hyperreactivity/therapy , Cough/etiology , Delphi Technique , Dyspnea/etiology , Glucocorticoids/therapeutic use , Humans , Lung/virology , Nebulizers and Vaporizers , Oxygen Inhalation Therapy , Patient Care Team , Protein Kinase Inhibitors/therapeutic use , Respiratory Therapy , SARS-CoV-2 , Stress Disorders, Post-Traumatic/etiology , Stress Disorders, Post-Traumatic/therapy , Time Factors , Tomography, X-Ray ComputedABSTRACT
With first cases noted towards the end of 2019 in China, COVID-19 infection was rapidly become a devastating pandemic. Even if most patients present with a mild to moderate form of the disease, the estimated prevalence of COVID-19-related severe acute respiratory failure (ARF) is 15-20% and 2-12% needed intubation and mechanical ventilation. In addition to mechanical ventilation some other techniques of respiratory support could be used in some forms of COVID-19 related ARF. This position paper of the Respiratory Support and Chronic Care Group of the French Society of Respiratory Diseases is intended to help respiratory clinicians involved in care of COVID-19 pandemic in the rational use of non-invasive techniques such as oxygen therapy, CPAP, non-invasive ventilation and high flow oxygen therapy in managing patients outside intensive care unit (ICU). The aims are: (1) to focus both on the place of each technique and in describing practical tips (types of devices and circuit assemblies) aimed to limit the risk of caregivers when using those techniques at high risk spreading of viral particles; (2) to propose a step-by-step strategy to manage ARF outside ICU.