Macroeconomic consequences of the COVID-19 pandemic.

We estimate the economic impacts of COVID-19 in the U.S. using a disaster economic consequence analysis framework implemented by a dynamic computable general equilibrium (CGE) model. This facilitates identification of relative influences of several causal factors as "shocks" to the model, including mandatory business closures, disease spread trajectories, behavioral responses, resilience, pent-up demand, and government stimulus packages. The analysis is grounded in primary data on avoidance behavior and healthcare parameters. The decomposition of the influence of various causal factors will help policymakers offset the negative influences and reinforce the positive ones during the remainder of this pandemic and future ones.

Clinic-ventilatory differences between patients with orotracheal intubation due to COVID-19 with criteria for tracheotomy compared with those without criteria.

OBJECTIVE: To describe some characteristics among patients with orotracheal intubation due to coronavirus disease SARS-CoV-2 (COVID-19) hospitalized in the intensive care unit, who were candidates for tracheotomy, comparing against those who were not candidates for this procedure and that finally died. MATERIALS AND METHODS: A retrospective, descriptive, cross-sectional study of a series of two groups was carried out from April 2020 to March 2021 at Hospital de Especialidades no. 2 Lic. Luis Donaldo Colosio Murrieta, IMSS, Ciudad Obregon, Sonora, Mexico. Variables such as age, sex, comorbidities, time of orotracheal intubation, ventilatory parameters, blood gases and the Kirby index were included. RESULTS: There were included 41 cases, from which 29 were males;mean age was of 56 years;92.6% had at least one comorbidity. Group of tracheotomy included 21 patients. Previous ventilatory parameters were: PEEP: 7.61, FiO2: 41.42, blood gas with pH: 7.42, pO2: 95.04, pCO2: 41.47, HCO3: 29.14, O2 saturation: 94.7%, Kirby index: 235. In the not-operated group due to death it was found: PEEP: 9.5, FiO2: 82.3%, blood gas pH: 7.33, pO2: 62.45, pCO2: 58.5, HCO3: 30.9, O2 saturation: 86.5%, Kirby index: 81.8. CONCLUSIONS: We believe that PaO2/FiO2 (Kirby index) = 81.8 could be related to high morbidity due to the disease, considering patients not candidates for the tracheostomy procedure. (English) [ FROM AUTHOR] OBJETIVO: Describir algunas características clínico-ventilatorias de los pacientes con intubación orotraqueal por enfermedad por coronavirus SARS-CoV-2 (COVID-19) hospitalizados en la unidad de cuidados intensivos, que fueron aptos a traqueotomía en comparación contrra los no aptos a este procedimiento y que finalmente fallecieron. MATERIALES Y MÉTODOS: Estudio retrospectivo, descriptivo, transversal efectuado de abril de 2020 a marzo de 2021 en el Hospital de Especialidades núm. 2 Lic. Luis Donaldo Colosio Murrieta, IMSS, Ciudad Obregón, Sonora, México. Se incluyeron variables como edad, sexo, comorbilidades, tiempo de intubación orotraqueal, parámetros ventilatorios, gasométricos y el índice de Kirby. Los pacientes se dividieron en dos grupos: a los que se les realizó traqueotomía y a los que no y que además fallecieron. RESULTADOS: Se incluyeron 41 pacientes, de los que 29 eran del sexo masculino, la edad media fue de 56 años;el 92.6% tenía al menos una comorbilidad. El grupo operado de traqueotomía incluyó 21 pacientes. Los parámetros ventilatorios previos fueron: PEEP: 7.61, FiO2: 41.42, gasometría con pH: 7.42, pO2: 95.04, pCO2: 41.47, HCO3: 29.14, saturación O2: 94.7%, índice de Kirby: 235. En el grupo no operado por fallecimiento se encontró: PEEP: 9.5, FiO2: 82.3%, gasometría pH: 7.33, pO2: 62.45, pCO2: 58.5, HCO3: 30.9, saturación O2: 86.5%, índice de Kirby: 81.8. CONCLUSIONES: Creemos que la PaO2/FiO2 (índice de Kirby) = 81.8 pudiera relacionarse con alta morbilidad por la enfermedad, considerando a los pacientes no aptos al procedimiento de traqueotomía. (Spanish) [ FROM AUTHOR] Copyright of Medicina Interna de Mexico is the property of Colegio de Medicina Interna de Mexico and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

Impact of tracheostomy in patients with severe acute respiratory syndrome due to coronavirus infection

OBJECTIVE. To estimate the effect of tracheostomy on ventilation in patients with COVID-19. MATERIAL AND METHODS. An observational, retrospective, analytical, longitudinal study of a consecutive series of cases was carried out between April 2020 and March 2021. The study included data about different variables, such as age, sex, comorbidities, time of orotracheal intubation, place of surgery, complications and death, ventilatory parameters, blood gas and time of the weaning after tracheostomy. Descriptive statistics were used with measures of central tendency, measures of dispersion and the Wilcoxon test to see differences in the ventilatory parameters. RESULTS. The study was performed on 130 patients admitted to the ICU with intubation to manage their critical condition. From these patients, the study group included 31 who underwent tracheostomy, 25 males (80.64%) with a mean age of 57.1±13.395 years and with 20.52±6.722 days in orotracheal intubation. Among the most frequent comorbidities, we encountered: arterial hypertension (51.6%), obesity (35.4%), diabetes mellitus (22.5%), hypothyroidism (6.4%), asthma (3.2%), pregnancy (3.2%), chronic obstructive pulmonary disease (3.2%) and obstructive sleep apnea syndrome (3.2%). The main complications were bleeding (12.9%) and decannulation (3.2%). The survival rate was 90.32%. Comparing the pre-surgical and postoperative outcomes of the ventilatory parameters and blood gas, statistically significant differences were found only in case of PEEP (p = 0.033), FiO2 (p = 0.001) and O2 saturation (p = 0.001). The average removal of the ventilator was 4.3±2.437 days. CONCLUSION. There were no significant changes in the ventilatory parameters, however, they were sufficient to wean the patients from the ventilation team and discharge them to the internal medicine department to continue their management outside the intensive care unit. [ FROM AUTHOR] Copyright of Romanian Journal of Rhinology is the property of Romanian Rhinologic Society and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

Tracheostomy in patients with high suspicion or diagnosis of COVID-19: case series from two hospitals in Northwestern Mexico

OBJECTIVE. To describe the results of tracheostomy in a series of cases in patients with COVID-19 admitted to the intensive care unit in two hospitals in the Northwest Mexico. MATERIAL AND METHODS. A prospective, descriptive, longitudinal study was carried out on a series of cases from April 2020 to August 2020. Data such as age, sex, hospital of origin, risk factors for the development of severe COVID-19, ventilatory and gasometric parameters before and 72 hours after, the days of oro-tracheal intubation were taken into account. Descriptive statistics with frequencies and percentages were used for the qualitative variables, for the numerical measures of central tendency as the mean and the median, the distribution of the results. RESULTS. From April to August 2020, in the two Intensive Care Units (ICUs) of these hospitals, 134 COVID-19 cases were admitted. In 14 patients (10.4%) tracheotomies were performed, 13 (92.8%) were male, mean age 49.21 years, 85% tested positive. The mean duration of oro-tracheal intubation was 22.7. Obesity combined with diabetes and arterial hypertension represented a risk factor in 57.1% of the cases. In 10 patients, the procedure was performed in the ICU bed. There were changes in some ventilatory parameters before and 72 hours after the procedure. The average number of days after weaning from the ventilator was 5.5 days. There were 3 deaths in our series. CONCLUSION. The adequate and prudent selection of COVID-19 patients for tracheostomy makes it easier to choose with greater justification the patients with the best prognosis, avoiding unnecessary procedures in a patient and a greater risk of contagion in the personnel. [ABSTRACT FROM AUTHOR] Copyright of Romanian Journal of Rhinology is the property of Romanian Rhinologic Society and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)