EXPERIENCE OF HEALTH WORKERS DURING THE FIRST WAVE OF COVID-19 IN SPAIN: A QUALITATIVE STUDY WITH FOCUS GROUPS

Objectives: to analyze the experience of health professionals who provided first-line care to infected patients during the COVID-19 pandemic during the first wave. Material and Methods: Participants were recruited from among physicians and nurses in several hospitals and health centers in Spain. Narratives were obtained through three focus groups. Qualitative methodology was used according to exploratory, inductive, and ethnographic principles. Results: The experience of the health personnel was classified into six categories: The reaction and organization of health workers, materials and tests, emotional aspects of care, ethical conflicts, health management of the pandemic, and the social role of health workers. Conclusions: Healthcare workers took a proactive approach during the pandemic. Weaknesses and strengths in the provision of health care were.The capacity of emotional self-regulation of the health care workers is shown to be key to the ability of the health care system to continue operating. © 2022, Accion Medica S.A.. All rights reserved.

Risk factors associated with requiring invasive mechanical ventilation in patients with SARS-COV-2 infection: Experience in a tertiary care hospital in Mexico City

Background: The clinical presentation of SARS-CoV-2 disease ranges from asymptomatic respiratory infection to acute respiratory distress syndrome. Risk factors upon hospital admission associated with the need for invasive mechanical ventilation are not well documented. Methods: 185 hospitalized patients with confirmed COVID-19 were enrolled in this study, and they were classified as patients who required invasive mechanical ventilation and patients who did not require it. Comorbidities such as diabetes, high blood pressure, obesity, chronic lung disease and immunodeficiency were recorded. Laboratory studies were requested upon admission such as C-reactive protein, leukocyte and lymphocyte levels, D-dimer, troponin, serum ferritin and procalcitonin. Results: Of the patients who entered the study, 65 patients (35%) required invasive mechanical ventilation (IMV), while 120 (65%) did not require advanced airway management. Of the patients with invasive mechanical ventilation, age > 65 years, male sex, obesity (BMI > 30) and high blood pressure were the most frequent characteristics, presenting the latter two in 26% and 27% respectively. Regarding laboratory studies, the parameters most associated with the requirement for mechanical ventilation were a D-dimer (> 1000) and troponin (> 1), with 26% and 18%, respectively. Conclusion: This study showed the high proportion of obesity, hypertension and advanced age among patients who required invasive mechanical ventilation associated with SARS-CoV2 infection. The presence of elevated D-dimer and troponin on admission are associated with more severe presentations and a requirement for invasive mechanical ventilation.