Outcomes of tracheostomies performed in COVID-19 positive patients at Hospital Central del Estado Chihuahua, Mexico.

OBJECTIVE: Provide a description of clinical characteristics, associated factors and outcome of tracheostomies performed in COVID-19 patients. METHOD: Observational prospective study of 14 patients who underwent tracheostomy. 10 of them were diagnosed with COVID 19, confirmed with RT-PCR test of nasopharyngeal exudate and compatible tomographic findings. RESULTS: Of the 10 patients, five were discharged and five died. The average age of patients who died was 66.6 years; of those who were discharged, it was 60.4 years. Ventilatory parameters cut was taken as FiO2 ≤ 40% and PEEP ≤ 8; of the patients discharged, four met both criteria. On the other hand, of the patients who died, neither met both. Of the latter, an average of APACHE II of 16.4 and SOFA 7.4 were documented, while in discharged patients an average of 12.6 and 4.6 were observed, respectively. CONCLUSIONS: Tracheostomy performed in patients with specific criteria, such as low ventilatory parameters, age, or low score in severity scales, may have a better prognosis.

OBJETIVO: Realizar una descripción de las características clínicas, los factores asociados y el desenlace de las traqueostomías realizadas en pacientes con COVID-19. MÉTODO: Estudio retrospectivo observacional de 14 pacientes a quienes se realizó traqueostomía. Diez de ellos se encontraban diagnosticados con COVID-19, confirmada con prueba RT-PCR de exudado nasofaríngeo y hallazgos tomográficos compatibles. RESULTADOS: De los 10 pacientes, cinco fueron dados de alta y cinco fallecieron. La edad promedio de los pacientes que fallecieron fue de 66.6 años, y la de los que fueron dados de alta fue de 60.4 años. De los parámetros ventilatorios, se tomó como corte una FiO2 ≤ 40% y una PEEP ≤ 8; entre los pacientes dados de alta, cuatro cumplían con ambos criterios. En cambio, de los pacientes que fallecieron, ninguno los cumplió. En estos últimos se documentó un promedio de APACHE II de 16.4 y un SOFA de 7.4, mientras que en los pacientes dados de alta se observó un promedio de 12.6 y 4.6, respectivamente. CONCLUSIONES: La traqueostomía realizada en pacientes con criterios específicos, como parámetros ventilatorios bajos, edad o puntuación baja en las escalas de gravedad, pueden llegar a tener mejor pronóstico.

Invasive Pulmonary Aspergillosis in Patients with and without SARS-CoV-2 Infection.

The recent European Confederation of Medical Mycology (ECMM) and the International Society for Human and Animal Mycology (ISHAM) 2020 consensus classification proposes criteria to define coronavirus 2019 (COVID-19)-associated invasive pulmonary aspergillosis (CAPA), including mycological evidence obtained via non-bronchoscopic lavage. Given the low specificity of radiological findings in patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, this criterion makes it difficult to differentiate between invasive pulmonary aspergillosis (IPA) and colonization. This unicenter and retrospective study includes 240 patients with isolates of any Aspergillus species in any respiratory samples during a 20-month study (140 IPA and 100 colonization). Mortality was high in the IPA and colonization groups (37.1% and 34.0%, respectively; p = 0.61), especially in patients with SARS-CoV-2 infection, where mortality was higher in colonized patients (40.7% vs. 66.6.%; p: 0.021). Multivariate analysis confirmed the following variables to be independently associated with increased mortality: age > 65 years, acute or chronic renal failure at diagnosis, thrombocytopenia (<100,000 platelets/µL) at admission, inotrope requirement, and SARS-CoV-2 infection, but not the presence of IPA. This series shows that the isolation of Aspergillus spp. in respiratory samples, whether associated with disease criteria or not, is associated with high mortality, especially in patients with SARS-CoV-2 infection, and suggests an early initiation of treatment given its high mortality rate.

Trends, characteristics, and impact of global scientific production on mental health of health workers in the context of coronavirus disease 2019 (COVID-19).

BACKGROUND: Healthcare workers are under significant constant stress as a result of the coronavirus disease 2019 (COVID-19) pandemic. The aim of this study, therefore, was to analyze bibliometrically the impact, trend, and characteristics of scientific production related to the mental health of health professionals during the COVID-19 pandemic. MATERIALS AND METHODS: A bibliometric analysis of the scientific production on the mental health of health professionals and COVID-19 in Scopus from December 2019 to December 2021 was performed. An advanced search was designed using Boolean operators in Scopus and applied in April 2022. The metadata was entered into Microsoft Excel for the elaboration of the tables, SciVal to obtain the bibliometric indicators, and VosViewer to plot collaborative networks. RESULTS: A total of 1393 manuscripts, 1007 of which met the eligibility criteria, were found on the mental health of health workers and COVID-19. The country with the highest academic production was the United States and Harvard University with 27 manuscripts as the most productive institution. The scientific journal with the highest scientific production was the International Journal of Environmental Research and Public Health with 138 manuscripts and 1580 citations, and the author with the most citations per publication was Carnnasi Claudia with 69.8. CONCLUSION: The countries with the highest economic income occupy the first places in scientific production on the mental health of health workers during the COVID-19 pandemic, with the United States as the leader. There is a gap in the scientific knowledge on the mental health of healthcare workers during the COVID-19 pandemic in middle- and low-income countries.

Impact of Coronavirus Pandemic on Tuberculosis and Other Imported Diseases Screening among Migrant Minors in Spain.

BACKGROUND: In recent decades, the increase in population movements has turned the focus to imported diseases. The COVID-19 pandemic has negatively impacted the access to health care systems, especially in highly vulnerable populations. We address the effects of the pandemic on the health screening of migrant unaccompanied minors (UM) in Spain. METHOD: Retrospective cross-sectional study including UM screened for imported diseases with a unified protocol at a pediatric reference unit for tropical and infectious diseases in Madrid, Spain. We compared the pre-pandemic (2018-2019) and post-pandemic periods (2020-2021). RESULTS: A total of 192 minors were screened during the study period, with a drop in UM's referral to our center in the post-pandemic years (140 in 2018-2019 vs. 52 in 2020-2021). Out of 192, 161 (83.9%) were diagnosed with at least one medical condition. The mean age was 16.8 years (SD 0.8) and 96.9% were males. Most cases were referred for a health exam; only 38% of children were symptomatic. Eosinophilia was present in 20.8%. The most common diagnosis were latent tuberculosis infection (LTBI) (72.9%), schistosomiasis (15.1%), toxocariasis (4.9%) and strongyloidiasis (4.9%). The prevalence of LTBI did not vary significantly (69.3% vs. 82.7%, p = 0.087). A total of 38% of the patients diagnosed with LTBI never started treatment or were lost to follow-up, as were two out of three patients with active pulmonary tuberculosis. CONCLUSIONS: In this series, the number of UM referred for health screening has dropped dramatically after the COVID pandemic, and two years after the beginning of the pandemic, access to care is still limited. Lost to follow-up rates are extremely high despite institutionalization. Specific resources, including multidisciplinary teams and accessible units are needed to improve diagnoses and linkage to care in this vulnerable population.

Alveolar Proteinosis in COVID-19: Clinical Case.

Pulmonary alveolar proteinosis (PAP) is a rare, diffuse lung disease characterized by accumulation of lipoprotein in lung surfactant in the alveolar space and terminal bronchioles, leading to impaired gas exchange and arterial hypoxemia. We present the case of a 51-year-old woman who was admitted with a diagnosis of severe SARS-CoV-2 pneumonia. Her condition did not improve with corticosteroids. A chest CT scan revealed ground-glass opacities in all lung lobes, with septal thickening. A differential diagnosis was proposed with other diseases. Bronchoscopy revealed milky bronchoalveolar lavage fluid, and staining with periodic acid-Schiff was positive, thus indicating PAP. Therefore, the patient underwent whole lung lavage, which led to clinical, radiological, and functional improvement. In the context of the COVID-19 pandemic, differential diagnosis ensures that appropriate attention is given to less prevalent entities such as PAP.

Evaluación de las creencias hacia la atención de personas con discapacidad auditiva, en prácticas a distancia de Educación Física de estudiantes universitarios durante la pandemia por COVID-19 (Evaluation of beliefs towards the care of people with hearin

Objective: To evaluate the beliefs towards attention to disability in physical activity, in students of Bachelor's Degree in Physical Activity and Sport when carrying out virtual Physical Education teaching practices during the COVID-19 pandemic to schoolchildren with hearing disabilities. Method: Through a quasi-experimental quantitative approach of a quantitative type, 17 undergraduate students in Physical Activity and Sports from the Faculty of Sports of the Autonomous University of Baja California were trained, who carried out teaching practices, implementing 12 classes of Physical Education online to schoolchildren with hearing disability, planning, designing and applying pedagogical strategies according to their condition. Before and after, social and professional attitudes towards people with disabilities were evaluated. Results: The statistical analysis with t-Student test for independent samples reported significant differences (p <0.05), the average of the 30 items of the instrument before the teaching practices was 2.6 and after the teaching practices 1.9 with a change percentage of -29 Δ%. Conclusion: Beliefs towards attention to disability were improved through physical activity online educational environment, which is favorable in the teaching-learning process of participating students, providing elements for the development of future effective and adequate interventions in populations with disability. Alternate : Objetivo: Evaluar las creencias hacia la atención a la discapacidad en actividad física, en estudiantes de Licenciatura en Actividad Física y Deporte al realizar prácticas docentes de Educación Física a distancia durante la pandemia por COVID-19 a escolares con discapacidad auditiva. Método: Mediante un enfoque cuantitativo cuasiexperimental, se capacitó a 17 estudiantes de Licenciatura en Actividad Física y Deporte de la Facultad de Deportes de la Universidad Autónoma de Baja California, que realizaron prácticas docentes, implementando 12 clases de Educación Física a distancia a escolares con discapacidad auditiva, planeando, diseñando y aplicando estrategias pedagógicas acordes a su condición. Antes y después se evaluaron las actitudes sociales y profesionales hacia las personas con discapacidad. Resultados: El análisis estadístico con test t-Student para muestras independientes reportó diferencias significativas (p<0.05), el promedio de los 30 ítems del instrumento antes de las prácticas docentes fue 2.6 y después de las prácticas docentes 1.9 con un porcentaje de cambio de -29 Δ %. Conclusiones: Se mejoraron las creencias hacia la atención a la discapacidad a través de la actividad física, en un ambiente educativo a distancia, que es favorable en el proceso de enseñanza-aprendizaje de los estudiantes participantes, lo cual favorecerá competencias futuras para el desarrollo de intervenciones efectivas y adecuadas en poblaciones con discapacidades.Alternate :Objetivo: Avaliar as crenças em relação à atenção à deficiência na atividade física, em alunos do Curso de Bacharelado em Atividade Física e Esporte, na realização de práticas de ensino de Educação Física a distância durante a pandemia COVID-19 para escolares com deficiência auditiva. Método: Por meio de uma abordagem quantitativa quase experimental, foram treinados 17 alunos de graduação em Atividade Física e Esportes da Faculdade de Esportes da Autonomous University of Baja California, que realizaram práticas de ensino, implementando 12 aulas de Educação Física a distância para escolares com deficiência auditiva, planejando, elaborando e aplicando estratégias pedagógicas de acordo com sua condição. Antes e depois, foram avaliadas as atitudes sociais e profissionais em relação às pessoas com deficiência. Resultados: A análise estatística com teste t de Student para amostras independentes relatou diferenças significativas (p <0,05), a média dos 30 itens do instrumento antes das práticas de ensino foi de 2,6 e após as práticas de ensino 1,9 com um ercentual de mudança de -29 Δ%. Conclusões: As crenças na atenção à deficiência foram aprimoradas por meio da atividade física, em ambiente educacional a distância, o que é favorável no processo de ensino-aprendizagem dos alunos participantes, o que favorecerá futuras competências para o desenvolvimento de intervenções eficazes e adequadas nas populações com deficiência.

Actividad física evaluada en la clase de educación física en estudiantes de secundaria con discapacidad y sin discapacidad antes y durante la pandemia por COVID-19 (Physical activity assessed in physical education class in disabled and non-disabled high

Objective: To evaluate physical activity in physical education class in disabled and non-disabled high school students before and during the COVID-19 pandemic. Method: Participating subjects were high school students with an average age of 15.2 ± 5.7 years, 106 students without disabilities and 77 students diagnosed with disabilities, physical activity was evaluated before and during the COVID-19 pandemic using the international activity questionnaire IPAQ physics. Results: The analysis of variance (ANOVA) mixed 2 x 2 (groups x measurements), indicated that a statistically significant difference of p = .001 between the groups and p = .005 the measurements with the highest weekly energy expenditure of physical activity, in the student body without disabilities. Conclusions: When comparing the values ​​with an investigation that used the same methodological procedure, students with disabilities report higher sedentary habits than schoolchildren undiagnosed with disabilities, during the COVID-19 pandemic. Alternate : Objetivo: Evaluar la actividad física en la clase de educación física en estudiantado de secundaria con discapacidad y sin discapacidad antes y durante la pandemia por COVID-19. Método: Los sujetos participantes fueron estudiantes de secundaria con una edad promedio de 15.2±5.7 años, 106 estudiantes sin discapacidad y 77 estudiantes diagnosticados con discapacidad, la actividad física se evaluó antes y durante la pandemia por COVID-19 mediante el cuestionario internacional de actividad física IPAQ. Resultados: El análisis de varianza (ANOVA) mixtas 2 x 2 (grupos x mediciones), indicó que una diferencia estadísticamente significativa de p=.001 entre los grupos y p=.005 las mediciones con mayor gasto energético semanal de actividad física, en el estudiantado sin discapacidad. Conclusiones: Al comparar los valores con una investigación que utilizó el mismo procedimiento metodológico, el estudiantado con discapacidad reporta mayores hábitos sedentarios que escolares no diagnosticados con discapacidad, durante la pandemia por COVID-19.Alternate :Objetivo: Avaliar a atividade física em aulas de educação física em alunos do ensino médio com e sem deficiência antes e durante a pandemia de COVID-19. Método: Os sujeitos participantes foram alunos do ensino médio com idade média de 15,2 ± 5,7 anos, 106 alunos sem deficiência e 77 alunos com diagnóstico de deficiência, a atividade física foi avaliada antes e durante a pandemia COVID-19 usando o questionário internacional de atividade física IPAQ. Resultados: A análise de variância (ANOVA) mista 2 x 2 (grupos x medidas), indicou uma diferença estatisticamente significativa de p = 0,001 entre os grupos ep = 0,005 as medidas com maior gasto energético semanal de atividade física, no corpo discente sem deficiência. Conclusões: Ao comparar os valores com uma pesquisa que utilizou o mesmo procedimento metodológico, os alunos com deficiência relataram hábitos sedentários mais elevados do que os escolares não diagnosticados com deficiência, durante a pandemia do COVID-19.

Actividad física en estudiantes deportistas universitarios, previo y en el confinamiento por pandemia asociada al COVID-19 (Physical activity in university student athletes, prior and in confinement due to pandemic associated with COVID-19)

Objective: To compare the levels of physical activity in university athletes before and during the confinement due to pandemic associated with COVID-19. Method: thirty-two university student athletes enrolled in the Sports Faculty of the Autonomous University of Baja California. The average age of the participating subjects was 21.4 ± 3.6 years (17 men and 15 women). To assess the physical activity level, the international physical activity questionnaire (IPAQ) was used;measurements were carried out before and during confinement by COVID-19. Results: To determine equality of variance, the Student's t-test for independent samples was applied, with less physical activity (-33.6 Δ%), MET-minutes/week during confinement by COVID-19 (p=.005). Conclusions: Despite decreasing physical activity, the university athlete performed physical activity at home during confinement by COVID-19, harmonizing the time in the learning processes in their future profession. Alternate : Objetivo: Comparar los niveles de actividad física en deportistas universitarios antes y durante del confinamiento por pandemia asociada al COVID-19. Método: treinta y dos estudiantes deportistas universitarios matriculados en la Facultad de Deportes de la Universidad Autónoma de Baja California. La edad promedio de los sujetos participantes fue 21.4±3.6 años (17 hombres y 15 mujeres). Para evaluar los niveles de actividad física, se utilizó el cuestionario internacional de actividad física (IPAQ), las mediciones se llevaron a cabo previo y en el confinamiento por pandemia asociada al COVID-19. Resultados: Para determinar la igualdad de varianza, la prueba t de Student para muestras independientes que resultó con menor actividad física (-33.6 Δ%), MET-minutos/semana antes que durante el confinamiento por COVID-19 (p=.005). Conclusiones: A pesar de disminuir la actividad física, el deportista universitario realizó actividad física en su hogar durante el confinamiento por COVID-19, armonizando el tiempo en los procesos de aprendizaje en su futura profesión.Alternate :Resumo. Objetivo: Comparar os níveis de atividade física em atletas universitários antes e durante o confinamento por pandemia associada ao COVID-19. Método: trinta e dois atletas universitários matriculados na Faculdade de Esportes da Autonomous University of Baja California. A idade média dos sujeitos participantes foi de 21,4 ± 3,6 anos (17 homens e 15 mulheres). Para avaliar o nível de atividade física, foi utilizado o questionário internacional de atividade física (IPAQ);as medições foram realizadas antes e durante o confinamento pelo COVID-19. Resultados: Para determinar a igualdade de variância, foi aplicado o teste t de Student para amostras independentes, com menor atividade física (-33,6 Δ%), MET-minutos / semana durante o confinamento pelo COVID-19 (p = 0,005). Conclusões: Apesar de diminuir a atividade física, o atleta universitário realizou atividade física em casa durante o confinamento pelo COVID-19, harmonizando o tempo nos processos de aprendizagem em sua futura profissão.

Factors associated with satisfaction and depressed mood among nursing home workers during the covid-19 pandemic.

AIMS AND OBJECTIVES: This paper aims to examine the satisfaction and depressed mood experienced by nursing home workers during the COVID-19 pandemic and associated variables. Specifically, to analyse the factors that may contribute to nursing home workers developing adaptive behaviours that promote satisfaction or, on the contrary, show characteristics associated with a negative mood. BACKGROUND: Nursing homes have faced unprecedented pressures to provide appropriately skills to meet the demands of the coronavirus outbreak. DESIGN: A cross-sectional survey design using the STROBE checklist. METHODS: Professionals working in nursing homes (n = 165) completed an online survey measuring sociodemographic and professional characteristics, burnout, resilience, experiential avoidance, satisfaction with life and depression. Data were collected online from April to July 2021, the time in which Spain was experiencing its fifth wave of COVID-19. Two multiple linear regression models were performed to identify salient variables associated with depressive mood and satisfaction. RESULTS: Resilience, personal accomplishment and satisfaction had a significant and negative relationship with depression and emotional exhaustion, depersonalisation and experiential avoidance had a positive relationship with depression. However, emotional exhaustion, depersonalisation and experiential avoidance had a negative and significant relationship with satisfaction and personal accomplishment, and resilience had a positive and significant relationship with satisfaction. In addition, it was found that accepting thoughts and emotions when they occur is beneficial for developing positive outcomes such as satisfaction. CONCLUSIONS: Experiential avoidance was an important predictor of the effects that the COVID-19 pandemic can have on nursing home workers. RELEVANCE TO CLINICAL PRACTICE: Interventions focusing on resources that represent personal strengths, such as acceptance, resilience and personal accomplishment, should be developed. NO PATIENT OR PUBLIC CONTRIBUTION: The complex and unpredictable circumstances of COVID's strict confinement in the nursing home prohibited access to the centres for external personnel and family members. Contact with the professionals involved could not be made in person but exclusively through online systems. However, professionals related to the work environment have subsequently valued this research positively as it analyses 'How they felt during this complicated process'.

COVID-19 pandemic lockdown responses from an emotional perspective: Family function as a differential pattern among older adults

Family can be an essential resource at times of loss or vital crisis. Loneliness and isolation in older adults might have serious negative consequences for their mental health. For this reason, this research aims to analyze the role of family function in the anxiety and depression experienced by older adults during the pandemic caused by COVID-19. Participants were 882 Spanish community-dwelling adults over 60 years of age. Sociodemographic characteristics, characteristics related to the coronavirus, self-perceived health, family function, avoidance, depression and anxiety were analyzed. Data suggest a buffering effect of family function on anxiety and depression during the pandemic. Furthermore, being unmarried or a female, greater fear of COVID-19, worse self-perceived health, greater avoidance, and worse family function were associated with higher levels of anxiety. Likewise, greater fear of COVID-19, poorer self-perceived health, greater avoidance, and poorer family function, were associated with greater depression. These results point out that family dysfunction is a predisposing factor for the development of the emotional problems of anxiety and depression in older people in potentially stressful and loss situations. (PsycInfo Database Record (c) 2022 APA, all rights reserved) (Spanish) La familia puede ser un recurso fundamental en momentos de perdidas y crisis vitales. La soledad y el aislamiento en personas mayores provocan consecuencias negativas para su salud mental. La presente investigacion analiza el rol de la funcion familiar en la ansiedad y depresion experimentadas por personas mayores durante la pandemia ocasionada por el COVID-19. Participaron 882 adultos mayores de 60 anos evaluandose caracteristicas sociodemograficas y del coronavirus, salud, funcion familiar, evitacion, depresion y ansiedad. Los datos sugieren un factor amortiguador de la funcion familiar sobre la ansiedad y depresion durante la pandemia. Ademas, no estar casado, ser mujer, mayor miedo al COVID-19, una peor salud autopercibida, mayor evitacion y una peor funcion familiar se asociaba con mayores niveles de ansiedad. Mientras que mayor miedo al COVID-19, una peor salud autopercibida, mayor evitacion y una peor funcion familiar se relacionaban con mayor depresion. Los resultados permiten senalar que la disfuncion familiar es un factor predisponente para el desarrollo de problemas emocionales de ansiedad y depresion en personas mayores en situaciones potencialmente estresantes y de perdida. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

Longitudinal Impact of the COVID-19 Pandemic on Older Adults' Wellbeing

Background The COVID-19 pandemic is a major stressful life event. This pandemic is causing significant changes in older adults' daily life affecting their physical and mental health. Psychological wellbeing is a protective variable when facing adverse circumstances, like the COVID-19 pandemic. This study analyzes the impact of COVID-19 on older adults' psychological wellbeing (personal growth and purpose in life) over time. Materials and Methods One hundred ninety-two people over 60 years old participated in a longitudinal study. Data were collected in three time points: during the lockdown on March 2020, when the lockdown finished (4 months after baseline), and during the third wave (10 months after baseline). We used latent growth curve models to assess the linear longitudinal trajectories of psychological wellbeing. Results Older adults did not show worse psychological wellbeing over time. Age has a positive impact on purpose in life. Furthermore, being a male, worrying about adverse effects of COVID-19, family functioning, resilience, personal growth, and acceptance associated with purpose in life. Discussion These results suggest that despite the difficult circumstances experienced during the COVID-19 pandemic, older adults have used protective variables for their psychological wellbeing.

The Revised Memory and Behavior Problems Checklist for Nursing Homes: Validation among Different Spanish Territories

Memory and behavioral difficulties among older people living in nursing homes can cause burden and other consequences in professional caregivers. There is a lack of instruments that evaluate these behaviors and their influence in formal caregivers. The aim of this study is to develop and psychometrically test—the Revised Memory and Behavior Problems Checklist for Nursing Homes (RMBPC-NH). A cross-sectional study was carried out. The sample was made up of 312 formal caregivers working in nursing homes from different territories in Spain, 87.5% were women and 12.5% were men. The average age of participants was 39 years (SD = 12.2). The sample was recruited from January 2019 to March 2020. Participants completed a self-administered questionnaire, which included sociodemographic information, and assessed quality of technical equipment, level of training, experience of working with older people, job satisfaction, professional quality of life, burnout, and conception of negative stereotypes held towards aging. The four-factor structure of the RMBPC-NH showed a good fit, namely in relation to memory, functional, and emotional factors, and other problems. It has shown adequate psychometric properties, internal consistency, and validity (correlations with professional quality of life, job satisfaction, burnout, and negative stereotypes). The RMBPC-NH is a useful instrument to evaluate the frequency of older people’s memory and behavior problems and professional caregivers’ burden. The practical application in nursing homes is discussed.

Post-COVID-19 persistent headache: A multicentric 9-months follow-up study of 905 patients.

BACKGROUND: Headache is a frequent symptoms of coronavirus disease 2019 (COVID-19). Its long-term evolution remains unknown. We aim to evaluate the long-term duration of headache in patients that presented headache during the acute phase of COVID-19. METHODS: This is a post-hoc multicenter ambisective study including patients from six different third-level hospitals between 1 March and 27 April 2020. Patients completed 9 months of neurological follow-up. RESULTS: We included 905 patients. Their median age was 51 (IQR 45-65), 66.5% were female, and 52.7% had a prior history of primary headache. The median duration of headache was 14 (6-39) days; however, the headache persisted after 3 months in 19.0% (95% CI: 16.5-21.8%) and after 9 months in 16.0% (95% confidence interval: 13.7-18.7%). Headache intensity during the acute phase was associated with a more prolonged duration of headache (Hazard ratio 0.655; 95% confidence interval: 0.582-0.737). CONCLUSION: The median duration of headache was 2 weeks, but in approximately a fifth of patients it became persistent and followed a chronic daily pattern.

Emotional distress among older adults during the COVID-19 outbreak: understanding the longitudinal psychological impact of the COVID-19 pandemic.

BACKGROUND: Older adults have proven their ability to overcome adversities throughout their life. This study aims to assess the impact of the COVID-19 pandemic on older adults' psychological distress (anxiety and depression) over time. METHODS: A community-dwelling Spaniard population (N = 192) completed a survey and reported on their sociodemographic characteristics, appraisal and personal resources. Older adults took part in a longitudinal online survey collected in April 2020 (during the lockdown restrictions) and at two subsequent time points 3 and 9 months after baseline (without lockdown restrictions and during the third wave of the pandemic respectively). RESULTS: Older adults did not evidence higher emotional distress than during the initial lockdown. Furthermore, depression remained stable and anxiety significantly decreased. Results also suggest that some sociodemographic characteristics, appraisals and personal resources are relevant. Older participants showed less anxiety than younger ones. Furthermore, being a male, resilience, and acceptance were related with the decrease of anxiety. Otherwise, fear of the COVID-19 outbreak and depression were related with the increase of anxiety. CONCLUSION: Older adults may adapt to the adverse pandemic impact by using more adaptive resources that reduce their distress. Efforts to ameliorate older adults' anxiety by focusing on older adults' personal resources should be considered.

Telemedicine follow-ups for COVID-19: Experience in a tertiary hospital.

INTRODUCTION: Telemedicine is an attractive option for the follow-up of paediatric patients with SARS-CoV-2 infection. The aim of this article is to describe the experience with telephone consultations in a tertiary hospital. PATIENTS AND METHODS: Retrospective descriptive study of children with confirmed or probable diagnosis of COVID-19 attended by telephone consultations in Hospital La Paz (Madrid) between March and June 2020. Patients were referred from the Emergency Department after being discharged from the hospital. Telephone consultations were made every 48 h until symptoms resolved, then weekly until completing 14 days without symptoms. RESULTS: A total of 72 children were included, with median age of 83.5 months [IQR = 16.3-157.5]. Of those 46 (63.9%) were male, and 14 (19.4%) had comorbidities. There were 32 (44.4%) hospital admissions. COVID-19 diagnosis was confirmed in 33 children by RT-PCR, and in 7 by serology tests. The seroconversion rate was 67.7% in those patients with a positive RT-PCR. Other infections were found in 7 patients (5 Mycoplasma pneumoniae, 1 parvovirus, and 1 CMV). Median symptom duration was 25.5 days [IQR = 13.8-37], while median follow-up duration was 28 days [IQR = 21-39]. The median number of telephone consultations per patient was 6 [IQR = 4-8]. Clinical worsening was reported in 19 (26.4%) during follow-up, and 14 (19.4%) were re-evaluated in the Emergency Department. One patient required hospital admission, but he had a favourable outcome. CONCLUSIONS: Children with suspected SARS-CoV-2 infection should be followed-up due to prolonged duration of symptoms, and the risk of clinical deterioration. Telephone consultations are a useful and safe alternative for the follow-up of patients with mild symptoms, and for children discharged from the hospital.