Ordering countries when managing COVID-19

Here we assess countries' management of the coronavirus 2019 (COVID-19) pandemic using the reliability measure P(X ≤ Y). In this management, all kind of strategies as interventions deployed by governments as well individuals' initiatives to prevent, mitigate, and reduce the contagion of this disease are taken into account. Also, typical customs practiced locally and influencing contagion are included. Regarding a number of countries and rates associated to deaths and incidence, orderings of countries about such management are established, by using the measure of reliability indicated above. In this way, countries are distinguished from each other depending on how they managed this pandemic. This kind of analysis may be extended to the management of other diseases. Copyright © 2023 Cadena and Méndez.

Prospective multicenter evaluation of the gastrointestinal manifestations of covid-19 in outpatients

Introduction: The global spread of the SARS-CoV-2 virus has resulted in a worldwide pandemic with important socio-health repercussions. Current clinical experience and several published retrospective studies suggest that digestive symptoms are common in infected patients. [1][2] The aim of this study was to evaluate the frequency of gastrointestinal (GI) symptoms and complications in patients with COVID-19 disease managed on an outpatient basis. Aims & Methods: International, multicenter, prospective cohort study was conducted in 18 centers from Latin America, Asia, Africa and Europe. Subjects ≥18 years old, with COVID-19 disease, managed on an outpatient basis were included. Followed up period was 6 months. Baseline characteristics, comorbidities, GI symptoms or complications, hospital admission, ICU admission and mortality data were collected. A descriptive analysis of the study results was performed. A multivariate analysis was carried out, evaluating the association of GI symptoms and complications with age, baseline characteristics, comorbidity and COVID-19 treatments received. The adjusted Odd Ratio (ORa) was calculated assuming a significance level of p <0.05. Results: The preliminary analysis included a total of 436 patients. The median age was 35 years, interquartile range (IQR) 27-48 years. Two hundred and ten patients (48.2%) were male. The median of age-adjusted Charlson Comorbidity Index was 0 (IQR 0-1). The most frequent GI symptoms were anorexia 216 (49.5%), diarrhea 207 (47.5%), nausea 134 (30.7%), abdominal pain 122 (28%) and abdominal distension 121 (27.8%). At 4-week follow- up, symptoms resolved in most cases. Multivariate analysis showed that nausea was associated with Ivermectin treatment ORa 3.24 (95% CI 1.11-9.43) p= 0.030;abdominal pain was associated with Hydroxychloroquine treatment ORa 5.27 (95% CI 1.52-18.19) p= 0.009;diarrhea was associated with age ORa 0.966 (95% CI 0.93-0.99), p= 0.020 and Hydroxychloroquine treatment ORa 6.9 (95% CI 1.55-30.79), p= 0. 011;abdominal distension was associated with body mass index ORa 1.147 (95% CI 1.05-1.24), p< 0.001 and Hydroxychloroquine treatment ORa 7.6 (95% CI 2.00-29.51), p= 0.003. Digestive complications were infrequent (1 gastritis, 2 duodenitis, 1 jejunal ulcer, 3 hypertransaminasemia, 1 enteritis, 1 colitis). Twenty-three patients (5.3%) required hospital admission, of whom 4 (0.9%) required ICU admission and 2 (0.5%) died. Conclusion: Anorexia, diarrhea, nausea, abdominal pain and abdominal bloating were common symptoms in patients with COVID-19 disease managed on an outpatient basis. GI complications were infrequent in patients with COVID-19 who do not require hospitalization. Treatment with Hydroxychloroquine and Ivermectin was associated with more GI symptoms in COVID-19 outpatients.