ABSTRACT
Background: Adequate glycemic control improves the prognosis of patients hospitalized for pneumonia associated with severe COVID-19. Objective: To evaluate the impact of hyperglycemia (HG) on the prognosis of patients hospitalized for severe pneumonia associated with COVID-19 in unvaccinated patients. Material and methods: Prospective cohort study. We included patients hospitalized from August 2020 to February 2021, with severe COVID-19 pneumonia, not vaccinated against SARS-CoV-2. Data was collected from admission to discharge. We used descriptive and analytical statistics according to the data distribution. ROC curves were used to determine the cut-off points with the highest predictive performance for HG and mortality, with the IBM SPSS program, version 25. Results: We included 103 patients, 32% women, 68% men, age 57 +/- 13 years;58% were admitted with HG (191, IQR 152-300 mg/dL) and 42% with normoglycemia (NG < 126 mg/dL). Mortality was higher in HG at admission 34 (56.7%) than in NG 13 (30.2%) (p = 0.008). HG was associated with diabetes mellitus 2 and neutrophilia (p < 0.05). The risk of death increases 1.558 times (95% CI 1.118-2.172) if HG is at admission and 1.43 times (95% CI 1.14-1.79) during hospitalization. Maintaining NG throughout the hospitalization contributed independently to survival (RR = 0.083 [95% CI 0.012-0.571], p = 0.011). Conclusion: HG significantly impacts prognosis by increasing mortality more than 50% during hospitalization for COVID-19. Copyright © 2023 Revista Medica del Instituto Mexicano del Seguro Social.
ABSTRACT
Background: COVID-19 brought with it unknowns related to systemic sclerosis. Objective: To know the clinical evolution and prognosis of COVID-19 in a cohort of patients with systemic sclerosis. Methods: During the pandemic, we had digital contact with a cohort of 197 patients with SSc. If they had any condition that met the suspected definition of COVID-19, they underwent polymerase chain reaction testing for SARS-CoV-2;they were treated on an outpatient or hospital basis without interfering with their treatment. They followed their evolution every 24 hours until they became asymptomatic or died. Results: Thirteen patients (6.6%), nine diffuse cutaneous (dcSSc), and four limited cutaneous (lcSSc) developed COVID-19 during nine months of follow-up. The immunosuppressants used at the time of the disease were: mycophenolate mofetil, methotrexate, and prednisone, in low doses. Seven patients had interstitial lung disease (ILD). The main symptoms were chest pain, cough, dyspnea, dysgeusia, and anosmia, 1 with mild symptoms without pneumonia, 11 with mild pneumonia, and one with severe pneumonia that required hospital management. Only one (7.7%) presented severe pneumonia, was hospitalized, and died. Conclusions: COVID-19 disease in patients with SSc can be overcome in most cases, even when they are ILD and were using immunosuppressants at the time of infection with the SARS-CoV-2 virus. Copyright © 2023 Revista Medica del Instituto Mexicano del Seguro Social.
ABSTRACT
Studies on the acceptance and rejection of vaccines, as well as the belief in conspiracy theories, and the lack of trust in governments and science, have been important to analyze the vaccination process against COVID-19 worldwide, but they have been quite limited, so far, in the case of Latin America. In this sense, the objective of this work is to describe the degree of acceptance or not of certain conspiracy beliefs about vaccines against COVID-19 in a sample of countries members in the Andean Community of Nations (CAN): Bolivia, Colombia, Ecuador and Peru. A descriptive cross-sectional study was designed in which 1835 people from Bolivia, Colombia, Ecuador and Peru participated. To evaluate these beliefs, the COVID-19 Vaccine Conspiracy Belief Scale (ECCV-COVID, Caycho-Rodriguez et al., 2022a) was used. The results indicate that Peru has the highest average score of conspiracy beliefs about vaccines against COVID-19. In addition, in the 4 countries, the lowest degree of acceptance is with the belief that "Vaccinating children against COVID-19 is harmful and this fact is hidden". In Colombia, Ecuador and Peru, the highest degree of acceptance is related to the conspiratorial belief that "Information on the safety of vaccines against COVID-19 is often invented." Finally, in Bolivia, the highest degree of acceptance is with the belief that "Pharmaceutical companies hide the dangers of vaccines against COVID-19". The results presented in this study are the first known generically in the Latin American population, and particularly in the Andean population.
ABSTRACT
This study assesses the relationship between COVID-19 anxiety and subjective well-being in terms of the mediating role of COVID-19 preventive behaviors. Additionally, the contribution of sociodemographic factors (sex and age) and risk perception on COVID-19 anxiety and its potential measurement invariance was tested in 5655 participants from 12 countries in Latin America and the Caribbean. A mixture of both latent and observable variables were analyzed using a system of structural equations. The Coronavirus Anxiety Scale (CAS), Preventive COVID-19 Infection Behaviors Scale (PCIBS) and single-item measures were used to assess the perceived probability of death, perceived severity and concern about transmitting COVID-19. The results indicated that there is a significant and relevant direct effect of COVID-19 anxiety on participants' well-being. Furthermore, COVID-19 anxiety significantly predicted both preventive behavior (beta = .29, p < .01) and well-being (beta = -.32, p < .01). The effects of COVID anxiety and preventive behavior explained 9.8% of the variance in well-being (R-square = .098);whereas, 8.4% of the variance in preventive behavior was associated with COVID anxiety (R-square = .084). Likewise, perceived likelihood of death from COVID, perceived severity of COVID, and concerns about COVID transmission were positively related to anxiety. Age was negatively related to anxiety, with men being less anxious than women. The results are invariant by country, i.e., the broad relationships found in the combined sample are also present in each individual country. The findings indicate that, although the exact relationships between variables may vary between countries, there are enough similarities to provide useful information about the impact of the COVID-19 pandemic in each of the countries included in the study.
ABSTRACT
BackgroundCalls regarding children make up the relatively largest proportion of contacts to medical call-centers, with calls often concerning respiratory symptoms. Triage of children without visual cues and through second-hand information is difficult, with risks of over- and undertriage. We aimed to test feasibility, acceptance and patient outcome after introduction of video triage of young children at the out-of-hours medical call-center in Copenhagen, Denmark.MethodProspective quality improvement study, with patients aged 6 months to 5 years with respiratory symptoms enrolled to video or standard telephone triage (1:1). Calculated sample size was 774. The proportion of successful video calls, representing feasibility, and parental acceptance of video participation was registered, along with patient outcome within 48 hours, including adverse events (intensive care unit admittance, lasting injuries, death).ResultsWe included 617 patients (54% video triage) before the study prematurely was shut-down due to the COVID-19 pandemic. Feasibility was 95.2% and acceptance rate likewise 95.2%. No adverse events were registered in either group. Patients were triaged to stay at home in 63% of video triage calls vs. 58% of telephone triage calls (p=0.19). Within 8 and 24 hours there was a trend towards fewer video triaged than telephone triaged patients assessed at hospitals: 39% versus 46% (p=0.07) and 41% versus 49% (p=0.07), respectively.ConclusionVideo triage of young children with respiratory symptoms at a medical call-center was feasible, acceptable and safe. Video triage can potentially optimize triage and hospital referrals, and might be beneficial in many pediatric call-center contacts.Conflict of interestNone to declare.FundingTryg Foundation, Research Foundation of the Capital Region, Research Foundation of Amager-Hvidovre Hospital.
ABSTRACT
BACKGROUND: The possibility that the blood group (BG) predisposes to SARS-CoV-2 infection is controversial. OBJECTIVE: To compare the prevalence of BG, anti-IgG SARS-CoV-2, and more frequent symptoms in convalescent health personnel vs controls prior to vaccination. MATERIAL AND METHODS: Analytical cross-sectional design of cases and controls, which included health personnel, from March to June 2020, confirmed with (polymerase chain reaction) PCR-SARS-CoV-2 and negative controls with PCR and anti-IgG-SARS-CoV-2. Participants were questioned concerning symptoms and BG was determined. It was used descriptive statistics and comparative analysis with chi squared, Fisher's exact test, Student's t, and Mann Whitney's U tests. RESULTS: Of 218 workers, 102 (46.8%) were confirmed cases for SARS-CoV-2 (convalescent) and 116 controls. The distribution of BG was similar between cases and controls, being BG-O + the most frequent (52.9%). The risk of becoming infected by SARS-CoV-2 for BG-O compared to BGNo-O showed a lower trend (odds ratio [OR] 0.725, 95% confidence interval [95% CI] 0.416-1.261, p = ns). The BG-A (28.4%) compared with BG-No-A (71.6%) showed a trend of increased risk in BG-A (OR 1.523, 95% CI 0.818-2.837, p = ns). The presence of SARS-CoV-2 IgG antibodies was 85% in the convalescent group. CONCLUSIONS: The prevalence of infected was proportionally higher for BG-A and lower for BG-O. About 15% did not develop SARS-CoV-2 antibodies after overcoming COVID-19 disease.
ABSTRACT
Objectives: The aim was to determine the clinical evolution and the prognosis of COVID-19 in a cohort of patients with systemic sclerosis (SSc). Methods: During the pandemic we had continuous contact by digital media with a cohort of 197 patients with SSc. If they presented a condition that met the suspicious definition of COVID-19 disease, the polymerase chain reaction test for SARS-CoV-2 was performed and their evolution was followed every 24 hours until they were asymptomatic, or death occurred. Patients with COVID-19 were treated on a regular basis by the outpatient or in-hospital without interfering with their treatment. Results: Thirteen patients, 57 years of age (range 50 to 77), 9 diffuse cutaneous (dcSSc) and 4 limited cutaneous (lcSSc) become ill with COVID-19 during 9 months of follow-up. Immunosuppressors drugs used at the time of illness were: 6 mycophenolate mofetil, 2 methotrexate, 4 low-dose of prednisone. Seven patients had interstitial lung disease (ILD). Main symptoms were chest pain, cough, dyspnea, dysgeusia and anosmia, 1 had mild symptoms without pneumonia, 11 had mild pneumonia and received outpatient treatment, 1 only one had severe pneumonia requiring hospital management. One used supplemental oxygen as part of her treatment for lung fibrosis but additionally 4 used it during her illness. Only one (7.7%) had severe pneumonia was hospitalized and died at 77 years of age. Three patients discontinued their immunosuppressants during the pandemic and among them was the patient who died. Image 1 Conclusion: COVID-19 disease in patients with SSc can be overcome in most cases, even when they have ILD and were using immunosuppressants at the time of contagion with the SARS-CoV-2 virus. The low aggressiveness of atypical pneumonia in these patients may be due to the existence of protective mechanisms that participate in the pathogenesis of SSc.
ABSTRACT
Studies on the acceptance and rejection of vaccines, as well as the belief in conspiracy theories, and the lack of trust in governments and science, have been important to analyze the vaccination process against COVID-19 worldwide, but they have been quite limited, so far, in the case of Latin America. In this sense, the objective of this work is to describe the degree of acceptance or not of certain conspiracy beliefs about vaccines against COVID-19 in a sample of countries members in the Andean Community of Nations (CAN): Bolivia, Colombia, Ecuador and Peru. A descriptive cross-sectional study was designed in which 1835 people from Bolivia, Colombia, Ecuador and Peru participated. To evaluate these beliefs, the COVID-19 Vaccine Conspiracy Belief Scale (ECCV-COVID, Caycho-Rodríguez et al., 2022a) was used. The results indicate that Peru has the highest average score of conspiracy beliefs about vaccines against COVID-19. In addition, in the 4 countries, the lowest degree of acceptance is with the belief that "Vaccinating children against COVID-19 is harmful and this fact is hidden". In Colombia, Ecuador and Peru, the highest degree of acceptance is related to the conspiratorial belief that "Information on the safety of vaccines against COVID-19 is often invented." Finally, in Bolivia, the highest degree of acceptance is with the belief that "Pharmaceutical companies hide the dangers of vaccines against COVID-19". The results presented in this study are the first known generically in the Latin American population, and particularly in the Andean population. © 2022 Instituto de Altos Estudios de Salud Publica. All rights reserved.