ABSTRACT
Objective Information from critically ill coronavirus disease 2019 (COVID-19) patients is limited and in many cases coming from health systems approaches different from the national public systems existing in most countries in Europe. Besides, patient follow-up remains incomplete in many publications. Our aim is to characterize acute respiratory distress syndrome (ARDS) patients admitted to a medical critical care unit (MCCU) in a referral hospital in Spain. Design Retrospective case series of consecutive ARDS COVID-19 patients admitted and treated in our MCCU. Setting 36-bed MCCU in referral tertiary hospital. Patients and participants SARS-CoV-2 infection confirmed by real-time reverse transcriptase–polymerase chain reaction (RT-PCR) assay of nasal/pharyngeal swabs. Interventions None Main variables of interest Demographic and clinical data were collected, including data on clinical management, respiratory failure, and patient mortality. Results Forty-four ARDS COVID-19 patients were included in the study. Median age was 61.50 (53.25 – 67) years and most of the patients were male (72.7%). Hypertension and dyslipidemia were the most frequent co-morbidities (52.3 and 36.4% respectively). Steroids (1mg/Kg/day) and tocilizumab were administered in almost all patients (95.5%). 77.3% of the patients needed invasive mechanical ventilation for a median of 16 days [11-28]. Prone position ventilation was performed in 33 patients (97%) for a median of 3 sessions [2-5] per patient. Nosocomial infection was diagnosed in 13 patients (29.5%). Tracheostomy was performed in ten patients (29.4%). At study closing all patients had been discharged from the CCU and only two (4.5%) remained in hospital ward. MCCU length of stay was 18 days [10-27]. Mortality at study closing was 20.5% (n 9);26.5% among ventilated patients. Conclusions The seven-week period in which our MCCU was exclusively dedicated to COVID-19 patients has been challenging. Despite the severity of the patients and the high need for invasive mechanical ventilation, mortality was 20.5%.
ABSTRACT
There is an extensive literature on the importance of the use of scientific evidence on teaching methods in higher education institutions. However, there is a gap in how evidence is used for decision making that affects students and staff in universities. This article is a contribution to the existing gap, making the analysis of a specific case on how Catalan universities have managed the decision making regarding their staff in the face of the pandemic situation with the COVID-19. In this article, through the interview with managers and faculty from different Catalan universities, it will be shown to what extent these university institutions have opted for decision making in the management of the situation based on scientific evidence or simply compliance with government regulations. © 2022, Hipatia Editorial. All rights reserved.
ABSTRACT
The successive crises experienced recently (financial crisis in 2008, refugees in 2015 and the current crisis resulting from COVID) have led to surges in discrimination, racism and lack of solidarity between groups. However, these same crises have inspired important manifestations of solidarity with a significant social impact (improving people’s lives) for many groups and in very different areas. This article focuses on two solidarity initiatives (interreligious language pairs and a cooperative) that contribute to overcoming inequalities and the social exclusion of the most vulnerable groups, to explore whether religious plurality and the interreligious dialogue present in these initiatives are a favourable element for solidarity. © 2021 by the authors. Licensee MDPI, Basel, Switzerland.
ABSTRACT
OBJECTIVE: Information from critically ill coronavirus disease 2019 (COVID-19) patients is limited and in many cases coming from health systems approaches different from the national public systems existing in most countries in Europe. Besides, patient follow-up remains incomplete in many publications. Our aim is to characterize acute respiratory distress syndrome (ARDS) patients admitted to a medical critical care unit (MCCU) in a referral hospital in Spain. DESIGN: Retrospective case series of consecutive ARDS COVID-19 patients admitted and treated in our MCCU. SETTING: 36-bed MCCU in referral tertiary hospital. PATIENTS AND PARTICIPANTS: SARS-CoV-2 infection confirmed by real-time reverse transcriptase-polymerase chain reaction (RT-PCR) assay of nasal/pharyngeal swabs. INTERVENTIONS: None MAIN VARIABLES OF INTEREST: Demographic and clinical data were collected, including data on clinical management, respiratory failure, and patient mortality. RESULTS: Forty-four ARDS COVID-19 patients were included in the study. Median age was 61.50 (53.25 - 67) years and most of the patients were male (72.7%). Hypertension and dyslipidemia were the most frequent co-morbidities (52.3 and 36.4% respectively). Steroids (1mg/Kg/day) and tocilizumab were administered in almost all patients (95.5%). 77.3% of the patients needed invasive mechanical ventilation for a median of 16 days [11-28]. Prone position ventilation was performed in 33 patients (97%) for a median of 3 sessions [2-5] per patient. Nosocomial infection was diagnosed in 13 patients (29.5%). Tracheostomy was performed in ten patients (29.4%). At study closing all patients had been discharged from the CCU and only two (4.5%) remained in hospital ward. MCCU length of stay was 18 days [10-27]. Mortality at study closing was 20.5% (n 9); 26.5% among ventilated patients. CONCLUSIONS: The seven-week period in which our MCCU was exclusively dedicated to COVID-19 patients has been challenging. Despite the severity of the patients and the high need for invasive mechanical ventilation, mortality was 20.5%.