Your browser doesn't support javascript.
Show: 20 | 50 | 100
Results 1 - 20 de 45
Filter
Add filters

Document Type
Year range
1.
Revista Virtual Universidad Catolica Del Norte ; 69:7-42, 2023.
Article in English | Web of Science | ID: covidwho-20236121

ABSTRACT

In Latin America there has been an important adaptation in terms of the development of postgraduate programs, educational processes have been reinvented and better opportunities have been generated to achieve competitiveness;This is how it is intended to identify problems. They are the most valued strategies under postgraduate curricular models or schemes so that they generate value in the academy and in society. The methodological support for this study was a literature review, guided by the PRISMA tool and from different databases, resulting in the pedagogical models or models having been transformed to understand the needs of users and the market, offering a better way to build training alternatives that contribute to the development of the economy and society. In Latin America, specifically in Colombia, articulation schemes are evident that benefit the way in which value strategies are built. It is concluded that, although progress has been made in the construction of competitive postgraduate programs, more innovation is required to achieve a true learning experience.

2.
Critical Care Conference: 42nd International Symposium on Intensive Care and Emergency Medicine Brussels Belgium ; 27(Supplement 1), 2023.
Article in English | EMBASE | ID: covidwho-2312227

ABSTRACT

Introduction: IL-6 has been correlated as a prognostic biomarker for worsening sepsis and COVID-19 as well as positive fluid balance for duration of mechanical ventilation [1, 2]. Method(s): We performed a retrospective cohort study to analyze the correlation between high levels of serum IL-6 and positive fluid balances in the first 24 h of ICU arrival with mechanical ventilation days. We included adult patient records of critical COVID-19 during 2020 from the High Specialty Regional Hospital Bicentenario 2010, all patients were intubated, received treatment according to guidelines inforced in that time. We obtained mean and standard deviation for continuous variables and frequencies for categorical variables, calculated Kolmogorov-Smirnov for non-parametric test and Spearman correlation, OR for severe hypoxemia, RRT. Result(s): We analyzed 102 patient records, 72% were male, mean age 54.8 years (SD 19.4), tracheostomy was performed in 8.8% of cases, mean APACHE II 16.7 (SD 8.4), values of inflammatory markers were C-reactive protein 108 mg/dl (SD 95), IL-6 118 pg/ml (SD 240), mean paO2/FiO2 was 150 mmHg (SD 82), 93% were on vasopressors, fluid balance mean was 1542 ml (SD 839), severe hypoxemia was present on 62.7% (P/F below 150 mmHg), prono was used in 47.1%, with an overall mortality occurred in 69%. We found no correlation between serum IL-6 levels and positive fluid balance with mechanical ventilation days and outcomes (rs -0.11 p = 0.23, Fig. 1). Elevated serum IL-6 + positive fluid balance at 24 h ICU arrival was associated with severe hypoxemia (OR 2.82, CI 95% 1.14-6.97, x2 p = 0.022), OR for discharge was non-significant (0.48 CI 0.19-1.20 p = 0.11), RRT (1.09 CI 95% 0.27-4.37, p = 0.9). Conclusion(s): In our study no correlation was found between serum IL-6 levels, positive fluid balance and mechanical ventilation days, but there was a significant association with severe hypoxemia.

3.
Revista de la Asociacion Espanola de Especialistas en Medicina del Trabajo ; 31(4):441-452, 2022.
Article in Spanish | EMBASE | ID: covidwho-2273262

ABSTRACT

Introduction: The studies of comparative law are used as a methodology of legal analysis based on the comparison of different applications and interpretations for similar cases, the interest in comparative law lies in that it nourishes and broadens the vision for international understanding, which makes us understand the rationale of the rules in different states, Of our interest is the concept of the Andean citizen and the migratory statute that defines that migrant workers from Bolivia, Colombia, Peru and Ecuador have additional rights, guarantees and duties to those of their country of birth, these new social rights are those granted since August 11, 2021 by decision 878 of the Andean migratory statute. When analyzing whether the health workers who attended the COVID-19, exposure to occupational biological risk was considered in each of their countries as of occupational origin, since the objective of the community is to standardize and normalize concepts and regulations and thus allow inferring whether they are entitled to the assistance and economic benefits covered to the worker Objective:To compare the legislation issued by the health authorities of the member countries of the Andean Community of Nations on COVID-19, and if this was configured as an Occupational Disease in health workers who attended the Pandemic. Material(s) and Method(s): An exhaustive review was carried out in the official communication channels of the health authorities of Colombia, Ecuador, Peru and Bolivia, CAN member countries, filtering the information on how they developed COVID-19 as an Occupational Disease in their internal regulations, identifying guarantees and protections provided by the countries to the health workers who have been in charge of the integral attention of this contingency. Descriptive study that included a search from April to December 2021. Result(s):After the review,COVID-19 was recognized as an Occupational Disease in health workers, in 3 of the 4 Countries, 1 of the Countries determined it as a Public Health problem, likewise it was found that each Country, approaches Occupational Risks differently, translating into the fact that Health Workers of the CAN, did not have guarantees and protections proper to the Occupational Risks system. Conclusion(s): There is a lack of development on the part of all the Countries that make up the CAN, with regard to aligning their regulations on labor risks, in such a way that they guarantee access to the Andean Citizen to enjoy the guarantees provided by social security in accordance with the supra-national regulation, Decision 584 which approves an instrument that establishes the fundamental rules on occupational safety and health, as a basis for the gradual and progressive harmonization of the laws and regulations governing the particular situations of the labor activities developed in each of the Member Countries, which are not fully developed by all the member countries, generating legal insecurity and uncertainty for the migrant worker.Copyright © 2022, Accion Medica S.A.. All rights reserved.

4.
Annals of Clinical and Laboratory Science ; 50(3):295-298, 2020.
Article in English | EMBASE | ID: covidwho-2261479

ABSTRACT

The 2019 novel coronavirus (SARS-CoV2) is the causal agent of the newly-termed Coronavirus Disease 2019 (COVID-19). In January 2020, the World Health Association (WHO) declared the COVID-19 as an epidemic. Abnormal coagulation parameters in COVID-19 patients currently are considered as prognostic factors of severity. Our aim is to summarize the current data available in the literature. Materials and Methods. An electronic search was performed in the Database of publications on coronavirus disease (COVID-19) of the World Health Organization. Thrombin Time (TT), Prothrombin Time (PT), Fibrinogen (FIB), Activated Partial Thromboplastin Time (APPT), and D-Dimer have been detected as parameters to study in every COVID-19 patient. Clinical Application. The coagulation function panel has been described to be altered in critical COVID-2019 patients. DIC, which plays an important role in advanced stage, is known to be associated with sepsis. Anticoagulant therapy, mainly with low molecular weight heparin (LMWH), appears to be associated with better prognosis in patients with severe COVID-19. Discussion. Coagulation function in patients with SARS-CoV2 infection is significantly deranged compared with normal patients. FIB and D-Dimer/FDP are the most significantly altered values and the early deetection of alteration could be useful to address therapies. D-Dimer/FDP (DD/FDP) alteration correlates with severity. Markedly elevated D-Dimer can be used to guide the introduction of anticoagulation therapy and evaluate prognosis of COVID-19. In every patient admitted with SARS-CoV2 infection PT, FIB, D-Dimer/FDP, and platelets must be ordered. We suggest daily extraction for every patient admitted and tested positive for COVID-19.Copyright © 2020 by the Association of Clinical Scientists, Inc.

5.
Journal of Museum Education ; 47(4):510-520, 2022.
Article in English | CAB Abstracts | ID: covidwho-2284560

ABSTRACT

During the COVID-19 pandemic, informal learning environments (ILEs) were forced to move programming online for the safety of staff and visitors. The Big Astronomy Project responded to the pandemic by releasing a planetarium show as a virtual YouTube 360 stream. This project was also utilized in the late stages of the pandemic in-person at planetarium theaters, offering an opportunity for comparison between two modalities of showing a planetarium program. In general, ILEs often have a clear ambition to spark interest and support existing interest in order to support continued engagement after a visit. We use the four-phase interest model to characterize and compare audience's prior interest levels between a virtual and in-person environment. We used focus groups and interviews with audience members consisting of 46 individuals across the 2 modalities. We found that the individuals who watched the show virtually tended toward later phases of interest compared to those who watched the show in-person. We also explore how different audiences rated their level of interest. Based on these results we suggest that the virtual and in-person activities may need to be targeted to different audience interest levels.

6.
Innov Aging ; 6(Suppl 1):850-1, 2022.
Article in English | PubMed Central | ID: covidwho-2212791

ABSTRACT

Background: Advanced age and coronary artery disease (CAD) have been associated with a dismal prognosis in patients infected with COVID-19, most likely due to the virus's thrombogenic effects. Older adults with a history of CAD have routinely used low-dose Aspirin (LDA) as prevention due to their increased risk of cerebro-cardiovascular events. However, it is unclear if this population would benefit from LDA when infected with COVID-19. Methods: A retrospective study was conducted using the PearlDiver database (PearlDiver Technologies, Fort Wayne, IN). Using ICD codes, patients aged 65–75 and Elixhauser Comorbidity Score(ECI)>4 with a history of CAD admitted for COVID-19 were identified. The use of LDA for 1 month before the index event was used to split the cohort into two matched groups by age, gender, ECI, and other cardiovascular diseases. Records of groups were reviewed for multiple outcomes 30 days after admission. Pearson's chi-squared test was used to compare groups. The strength of association was reported as Risk Ratios (RR). Results: 4,017 patients with no difference in the mean age, gender, and ECI were included in each group. No differences present in 30-days all-cause readmission(RR=1.04, CI95% =0.92–1.17, p=0.49), mortality(RR=0.63, CI95%=0.30–1.29, p=0.28), ICU admission(RR=1.01, CI95%=0.89–1.15, p=0.79), gastrointestinal bleeding(RR=1.09, CI95% = 0.85–1.40, p=0.51), and intracranial hemorrhage(RR=0.69, CI95%=0.26–1.83, p=0.62) between groups. Conclusion: LDA didn't improve the evaluated outcomes in older persons 30 days after admission. A plausible explanation is that COVID-19's thrombogenic mechanism is likely atypical.

7.
Journal of Museum Education ; 47(4):510-520, 2022.
Article in English | Scopus | ID: covidwho-2187316

ABSTRACT

During the COVID-19 pandemic, informal learning environments (ILEs) were forced to move programming online for the safety of staff and visitors. The Big Astronomy Project responded to the pandemic by releasing a planetarium show as a virtual YouTube 360 stream. This project was also utilized in the late stages of the pandemic in-person at planetarium theaters, offering an opportunity for comparison between two modalities of showing a planetarium program. In general, ILEs often have a clear ambition to spark interest and support existing interest in order to support continued engagement after a visit. We use the four-phase interest model to characterize and compare audience's prior interest levels between a virtual and in-person environment. We used focus groups and interviews with audience members consisting of 46 individuals across the 2 modalities. We found that the individuals who watched the show virtually tended toward later phases of interest compared to those who watched the show in-person. We also explore how different audiences rated their level of interest. Based on these results we suggest that the virtual and in-person activities may need to be targeted to different audience interest levels. © 2022 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.

8.
J Acad Consult Liaison Psychiatry ; 63:S128-9, 2022.
Article in English | PubMed Central | ID: covidwho-2119748
9.
Drones ; 6(9), 2022.
Article in English | Web of Science | ID: covidwho-2071295

ABSTRACT

This study aims to identify the factors associated with the adoption of drone delivery in Medellin, Colombia, in the context of the COVID-19 pandemic. For that purpose, it implemented the Diffusion of Innovation (DOI) theory and the Technology Acceptance Model (TAM), which have constructs that complement each other to determine the decision to accept a given technology. A survey was administered to 121 participants in order to validate the model proposed here, which is based on variables that reflect the perceived attributes and risks of this innovation and individuals' characteristics. The results indicate that the factors Performance Risk, Compatibility, Personal Innovativeness, and Relative Advantage of Environmental Friendliness have the greatest influence on Intention to Use Drone Delivery (mediated by Attitude Towards Drone Delivery). This paper offers relevant information for the academic community and delivery companies because few other studies have investigated this topic. Additionally, the proposed technology adoption model can be a benchmark for other emerging economies in similar social, economic, and technological conditions.

10.
13th International Conference on Mobile Computing and Ubiquitous Network (ICMU) ; 2021.
Article in English | Web of Science | ID: covidwho-1980890

ABSTRACT

Due to the influence of the new coronavirus, many people are interrupting fitness clubs and exercises/sports performed by multiple people. Under these circumstances, "core training," which can be easily performed indoors by individuals, attracts attention as an exercise to improve health. However, it isn't easy to recognize whether the posture during training is correct, significantly reducing effectiveness. This study developed 'CoreMoni,' a system to support individual core training, and verified its usefulness in supporting personal core training through evaluation experiments. We compared the duration of the correct posture of the plank with and without CoreMoni. The time spent on proper plank posture increased for 90% of the subjects. Besides, we used the System Usability Scale (SUS) and SUS's average score was 82 points, indicating that CoreMoni usability is excellent. Both quantitative and subjective assessments results suggest that CoreMoni supports individual core training by making users aware of posture and trunk vibration during core training.

11.
Revista del Pie y Tobillo ; 36(1):54-58, 2022.
Article in Spanish | EMBASE | ID: covidwho-1918295

ABSTRACT

Most of the time forefoot surgery requires the use of a tourniquet, and therefore, the surgery is usually performed with either a popliteal block or an ankle block. Surgical departments have traditionally relied on an anesthesiol-ogist to perform these procedures. The elective nature of the forefoot surgery and the lack of surgical anaesthetists due to the COVID-19 pandemic have become mandatory to find alternatives to continue performing these surgeries in order to avoid an increase of waiting lists. The foot and ankle wide-awake local anaesthesia with no tourniquet (WALANT) technique is an adaptation from the one used for hand surgery. This technique requires no sedation, no regional or general anaesthesia, and the patient is fully conscious during the operation. WALANT technique con-sists of administration of lidocaine and epinephrine for local anaesthesia and vasoconstriction. This technique allows the surgeon to perform the surgery with the patient fully awake and without a tourniquet. In addition, this gives the advantage to perform an intraoperative as-sessment of function. WALANT for foot and ankle surgery is a suitable, safe, and cheap technique. Taking into con-sideration the lack of anaesthetists, operating rooms, and hospital resources observed during SARS-CoV-2 epidemic, this technique represents an acceptable alternative to consider in order to be able to continue performing se-lected cases of foot and ankle surgery.

12.
Pediatric Dermatology ; 39(SUPPL 1):25-26, 2022.
Article in English | EMBASE | ID: covidwho-1916269

ABSTRACT

Objectives: To describe the clinical and laboratory characteristics of pediatric patients diagnosed with dermatomyosis during the COVID pandemic. Method: Description of the clinical and laboratory findings in patients under 15 years of age, who were admitted at our hospital with signs and symptoms suggestive of dermatomyositis, from March 2020 until November 2021. Results: Five patients, three boys and two girls, aged between 8 and 13 years, were diagnosed with juvenile dermatomyositis (JDM). The most frequent symptom was asthenia. Heliotrope erythema, malar rash, periungual erythema, and papules on elbows and knees were present in all cases. Three of our patients had perniosis on their toes. Four patients presented lesions in the oral mucosa, such as geographic tongue or gingivitis. The time between the onset of symptoms and the first visit with the pediatrician ranged from 1 to 6 months. In all cases, GOT/GPT enzymes, and aldolase were elevated at diagnosis, and the SARS-CoV-2 PCR was negative. Two patients had anti-TIF1 antibodies, and two had anti-MDA5 antibodies. In one girl, no specific autoantibodies for JDM were detected. Magnetic resonance imaging showed muscle oedema in all patients. All cases are in remission after systemic treatment with steroids, methotrexate or immunoglobulins. Discussion: JDM is a severe disease of childhood. Our cases did not present symptoms suggestive of COVID and the PCR for SARS-CoV-2 was negative on admission in all of them, but the presence of perniosis on the toes of three patients could correspond to “COVID toes,” and be a late manifestation of an asymptomatic or oligosymptomatic infection of SARS-CoV-2. It has been suggested that SARS-CoV-2 infection could trigger the development of JDM, possibly through the induction of IFNα. Long-term follow-up is necessary to establish a relationship between the prognosis of specific autoantibodies, the involvement of acral and mucosal areas, and the possible relation with COVID.

13.
AERA OPEN ; 8, 2022.
Article in English | Web of Science | ID: covidwho-1910233

ABSTRACT

We share school leaders' perspectives on Zoom videos concerning the needs of immigrant and refugee families in Title I schools. In these videos, participants crafted and shared personal narratives about their leadership experiences during the COVID-19 era of education. Rooted in participatory design research methods, the process of designing these videos were both a research project and an intervention to assist families and school leaders to better understand each other. We present a close analysis of administrators' perspectives and describe how our codesigned video methodology enabled participants to coconstruct new meanings of school-community relationships during the pandemic through a radical care framework. We conceptualize these reimaginings as aperturas-cracks in the dominant family engagement paradigm that allow us to collectively work towards transformative ends which we term community-centered school leadership. We conclude the article with recommendations for how both school leadership and research can approach and reimagine family engagement postpandemic.

14.
Aloma-Revista De Psicologia Ciencies De L Educacio I De L Esport ; 40(1):23-34, 2022.
Article in Spanish | Web of Science Web of Science | ID: covidwho-1885013

ABSTRACT

In mid-March 2020, the world suddenly stopped with the appearance of COVID-19. However, the need to continue formal education, go to work and maintain communication with others remained intact. Technologies have made it possible to carry out these activities digitally in a space of interaction called cyber-coexistence. This research analyses the psychometric properties of a questionnaire intended to measure cyber-coexistence in the context of teaching and learning processes during the health crisis. Recommendations based on the literature were considered in the construction and validation of the instrument, which was carried out through expert judgement and exploratory and confirmatory factor analysis. The instrument was administrated in June 2020 remotely to a convenience sample of 400 secondary and tertiary students from schools in the Biobio region, Chile. Factor analyses yielded a latent structure with an adequate fit to the data, consisting of 23 items divided into six underlying dimensions of the construct. Reliability analysis yields an internal consistency of .76 according to the Omega coefficient. Orientations for the regulation of the use of mobile devices to promote positive cyber-coexistence in educational context are offered.

15.
Clin Psychol Sci ; 10(5): 819-845, 2022 Sep.
Article in English | MEDLINE | ID: covidwho-1765400

ABSTRACT

The challenges observed in health service psychology (HSP) training during COVID-19 revealed systemic and philosophical issues that preexisted the pandemic, but became more visible during the global health crisis. In a position paper written by 23 trainees across different sites and training specializations, the authors use lessons learned from COVID-19 as a touchstone for a call to action in HSP training. Historically, trainee voices have been conspicuously absent from literature about clinical training. We describe longstanding dilemmas in HSP training that were exacerbated by the pandemic and will continue to require resolution after the pandemic has subsided. The authors make recommendations for systems-level changes that would advance equity and sustainability in HSP training. This article advances the conversation about HSP training by including the perspective of trainees as essential stakeholders.

16.
International Conference on Information Technology and Systems, ICITS 2022 ; 414 LNNS:52-61, 2022.
Article in English | Scopus | ID: covidwho-1750554

ABSTRACT

Due to the measures imposed to prevent the spread of the virus during the COVID-19 pandemic, how education and work communications are carried have changed. An increase in video conferencing and meeting applications is noticeable. In this research paper, we describe the results of a user experience evaluation of three widely used platforms: Discord, Microsoft Teams, and Zoom. Through the User Experience Questionnaire (UEQ) application, it was determined that Discord is better in aspects not related to tasks and provides an above-average UX. On the other hand, zoom excels when it comes to tasks, but in conjunction with Microsoft Teams, it delivers below-average UX. © 2022, The Author(s), under exclusive license to Springer Nature Switzerland AG.

17.
Open Forum Infectious Diseases ; 8(SUPPL 1):S172, 2021.
Article in English | EMBASE | ID: covidwho-1746738

ABSTRACT

Background. Antimicrobial resistance is a major public health threat internationally but, particularly in Colombia. High and increasing rates of carbapenemases are challenging. Implementing antimicrobial stewardship programs (AMSs) in a large, academic, public network hospitals in Bogotá, Colombia.will help curb inappropriate antibiotic use. Methods. AMS was established in April 2020 consisting of an administrative champion, Infectious Diseases staff, nurse, General Physician, microbiologist, and pharmacists. Antimicrobial stewardship program interventions included postprescriptive audit and establishment of institutional guidelines. The AMS tracked appropriate drug selection including loading dose, maintenance dose, frequency, route, duration of therapy, de-escalation, and compliance with AMS recommendations. Defined daily dose (DDD) of drugs and health economics evaluations of antimicrobials (April-December 2020). Recommendations are placed in the electronic medical record as a progress note. Results. From April to December 2020, 1013 patients were evaluated by means of a prospective methodology. Unnecessary 689 days of hospitalization and 4420 days of antibiotic therapy were avoided. Among the top antibiotics discontinued were piperacillin tazobactam for the months of July, August, November and December, while for September and October was meropenem. The intensive care unit was the most frequently intervened service (52%), followed by hospitalization (43%) and the emergency department (5%).Over the course of the year, there was significant adherence to the program, with 100% in July, followed by 93.3% in April, 87% in December, 86.6% in May and June, 83% in November, 80% in September, 73.3% in August and 57% in October. The AMS program was able to save $47.409US in antibiotics and $55.529US in hospitalization, and 11% decrease in nephrotoxicity events (14 renal failures were avoided), which also saved additionally $ 23.503 US for a total of an estimated cost saving for the network public hospitals of $ 126.441 US by 2020. Conclusion. Implementation of a multidisciplinary antibiotic stewardship program in this academic, large, academic, public network hospitals in Bogotá, Colombia demonstrated feasibility and economic benefits even in a Covid19 pandemic situation.

18.
Open Forum Infectious Diseases ; 8(SUPPL 1):S296, 2021.
Article in English | EMBASE | ID: covidwho-1746606

ABSTRACT

Background. Patients with severe SARS-CoV-2 infection are at high risk of complications due to the intensive care unit stay. Hospital-acquired infections (HAI) are one of the most common complication and cause of death in this group of patients, it is important to know the epidemiology and microbiology of this hospital-acquired infections in order to begin to the patients a proper empirical treatment. We describe the epidemiologic and microbiologic characteristics of HAI in patients with COVID-19 hospitalized at intensive care unit (ICU) in a tertiary level private hospital in Mexico City. Methods. From April to December 2020, data from all HAIs in patients with severe pneumonia due to SARS-CoV-2 infection with mechanical ventilation at ICU were obtained. The type of infection, microorganisms and antimicrobial susceptibility patterns were determined. Results. A total of 61 episodes of HAIs were obtained, the most common was ventilator associated pneumonia (VAP) in 52.4% (n=32) followed by urinary tract infection (UTI) 34.4%(n=21) and bloodstream infection (BSI) 9.84% (n=6). Only two episodes corresponded to C. difficile associated diarrhea. We identified 82 different microorganisms, the most frequent cause of VAP was P. aeruginosa 22% (10/45) followed by K. pneumoniae 20% (9/45);for UTI, E. coli 28.5% (6/21), and S. marcescens 19% (4/21);for BSI the most frequent microorganism was S. aureus 28.5 (2/7). Regarding the antimicrobial susceptibility patters the most common were Extended Spectrum Beta-Lactamase (ESBL) Gram-negative rods followed by Methicillinresistant Staphylococcus aureus. Conclusion. In patients with severe COVID-19 hospitalized in the ICU the most frequent HAIs were VAP and UTI caused by P. aeruginosa and E. coli respectively. ESBL enterobacteriaceae was the most common resistant pattern identifed in the bacterial isolations in our series.

19.
Emergencias ; 34(2):119-127, 2022.
Article in English, Spanish | MEDLINE | ID: covidwho-1738260

ABSTRACT

OBJECTIVES: Although many demographic and clinical predictors of mortality have been studied in relation to COVID-19, little has been reported about the prognostic utility of inflammatory biomarkers. MATERIAL AND METHODS: Retrospective cohort study. All patients with laboratory-confirmed COVID-19 treated in a hospital emergency department were included consecutively if baseline measurements of the following biomarkers were on record: lymphocyte counts, neutrophil-to-lymphocyte ratio NRL, and C-reactive protein (CRP) and procalcitonin (PCT) levels. We analyzed associations between the biomarkers and all-cause 30-day mortality using Cox regression models and dose-response curves. RESULTS: We included 896 patients, 151 (17%) of whom died within 30 days. The median (interquartile range) age was 63 (51-78) years, and 494 (55%) were men. NLR, CRP and PCT levels at ED presentation were higher, while lymphocyte counts were lower, in patients who died compared to those who survived (P .001). The areas under the receiver operating characteristic curves revealed the PCT concentration (0.79;95% CI, 0.75-0.83) to be a better predictor of 30-day mortality than the lymphocyte count (0.70;95% CI, 0.65-0.74;P .001), the NLR (0.74;95% CI, 0.69-0.78;P = .03), or the CRP level (0.72;95% CI, 0.68-0.76;P .001). The proposed PCT concentration decision points for use in emergency department case management were 0.06 ng/L (negative) and 0.72 ng/L (positive). These cutoffs helped classify risk in 357 patients (40%). Multivariable analysis demonstrated that the PCT concentration had the strongest association with mortality. CONCLUSION: PCT concentration in the emergency department predicts all-cause 30-day mortality in patients with COVID-19 better than other inflammatory biomarkers.

20.
Journal of Crohn's and Colitis ; 16:i204-i206, 2022.
Article in English | EMBASE | ID: covidwho-1722306

ABSTRACT

Background: This study aimed to compare the risk of COVID-19 in patients with IBD versus the general population, and to evaluate predictors of infection acquisition, progression to severe forms, and risk of developing persistent COVID-19. We also assess the differences between cases across the different COVID-19 pandemic waves in our target population. Methods: This single-centre prospective, cohort study included consecutive IBD patients diagnosed of COVID-19 either by a positive polymerase chain reaction test and/or antigen test in nasopharyngeal swabs, or by anti-SARS-CoV-2 antibodies, and that they had a follow-up of at least 4 months. Using logistic regression, we evaluated cases versus IBD controls included in the IBD Unit database for predictors of COVID-19 acquisition. COVID-19 cases were distributed according to pandemic waves. Cox regression analysis was used for predictors of severe and persistent COVID-19. Results: By May 31, 2021, 160 out of 1911 IBD patients (8.3%) were diagnosed with COVID-19. IBD patients had a similar adjusted incidence of COVID-19 (OR 0.94;95% CI 0.86-1.02;P=0.42), and a similar associated mortality ratio (OR 0.83;95% CI 0.6-1.06;P=0.48), compared to the general population. In multivariable analysis, treatment with biologics was associated with a higher risk (OR 2.22, P<0.001), and treatment with salicylates with a lower risk (OR 0.71, P=0.048) of contracting COVID-19.(Table 1) 62 COVID-19 cases were diagnosed during the first wave of pandemic (until the end of June 2020), and 54 and 44 cases during the second and third waves (until the end of December 2020 and May 2021, respectively).(Figure 1) In multivariate analysis, first wave cases were associated with a higher risk of progression to severe forms of infection (OR 4.76, 95% CI 1.83-12.37, P=0.001), and development of persistent COVID-19 (OR 2.4, 95% CI 1.16-4.95, P=0.018). 29 patients (18.1%) required hospitalisation and were classified as severe COVID-19, which was associated in multivariable analysis with age>48 (HR 3.68, P=0.007), cases diagnosed in the first wave (HR 6.04, P<0.001), and comorbidities (evaluated with Duke Severity of Illness Checklist [DUSOI], P<0.001).(Table 2) During a median follow-up of 8.4 months, 68 patients (42.5%) were diagnosed with persistent COVID-19. Multivariable analysis identified UC (P=0.053), comorbidities (P=0.090), and being diagnosed during the first wave (P=0.011) as risk factors for persistent COVID-19.(Table 3) Conclusion: IBD patients have a similar risk of COVID-19 and associated mortality as the general population. Cases diagnosed during the first wave of the pandemic had severe and persistent forms of COVID-19 more frequently. Age and comorbidity were the main risk factors for severe forms of the disease.

SELECTION OF CITATIONS
SEARCH DETAIL