[Functional evolution and mood of patients after admission for COVID-19 to intensive care unit]. / Evolución funcional y del estado de ánimo de pacientes tras ingreso por COVID-19 en una unidad de Cuidados Intensivos.

OBJECTIVE: Describe the functional situation of patients one and two months after admission for COVID-19 pneumonia in an intensive care unit (ICU) and affect their mood one month after hospital discharge. DESIGN: Prospective cohort study was carried out. PATIENTS: Patients admitted to the ICU for COVID-19 pneumonia during the months of February to July 2020. PRIMARY VARIABLES OF INTEREST: Demographic data, mortality, ICU stay and hospital stay, destination at discharge, functional status at baseline (Barthel Index), after discharge, at one month and two months, physiotherapy treatment and impact on mood (Hospital Anxiety and Depression Scale). RESULTS: 89 patients were admitted in ICU with a mortality rate of 48.3% in the ICU. Among the survivors, 42 patients completed the follow-up at two months. Functional deterioration was observed at ICU discharge in 97.6% and at hospital discharge in 76.2%. At follow-up, 66.7% of patients had recovered their baseline functional level one month after leaving the hospital and 85.7% had done so after two months. One month after discharge, 12% of the patients had results compatible with anxiety and 20% had results compatible with depression. CONCLUSIONS: Patients admitted to the ICU for COVID-19 pneumonia have high hospital mortality, and those who survive show severe functional deterioration after admission. Two months after hospital discharge, most survivors recover their baseline functional status and mood prior to admission.

[Impact of the Covid-19 pandemic on specialized healthcare training in a teaching center]. / Impacto de la pandemia COVID-19 en la formación sanitaria especializada en un centro docente.

OBJECTIVE: Evaluation of the impact of the health crisis caused by the Covid-19 pandemic on specialized healthcare training in a teaching center. METHODS: Cross-sectional descriptive study, by means of an electronic questionnaire sent to 167 residents in June 2020, to evaluate the burden of care, suspension of rotations and Covid-19 symptoms. The impact on the acquisition of professional competencies was measured using a four-level Likert scale (none, a little, quiet, a lot). The profile of acquired competencies was constructed and its association with the professional profile was studied using Generalized Linear Models. The qualitative approach was carried out through an open question on how it influenced their learning and the different categories were extracted through triangulation. RESULTS: The impact on learning was important for 94.8% of the residents. A total of 81.4% left the rotations they were doing and reported high workload, loss of training opportunities, uncertainty and ethical conflicts. They appreciated significant learning in the competencies of teamwork (93.2%), professionalism (86.2%), ethics (79.9%) and communication (78%). Technical competencies were deficient. The final balance of learning was perceived as positive by 54.4%, especially residents in central services and medical specialties. A total of 67.8% felt overwhelmed at times due to fatigue-emotional impact, care overload, ethical conflicts and lack of resources. CONCLUSIONS: The Covid-19 pandemic had an exceptional impact on specialized health care training. It is necessary to re-evaluate training programs to ensure the acquisition of the technical competencies that are lacking.