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Rev Invest Clin ; 2021 Mar 03.
Article in English | MEDLINE | ID: covidwho-1207969


BACKGROUND: Risk factors for coronavirus disease (COVID-19) and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) asymptomatic carriage (AC) in healthcare workers (HCWs) have been scarcely characterized. OBJECTIVE: The objective of the study was to study factors associated with COVID-19 and AC in HCWs of a COVID-19 academic medical center. METHODS: This is a case-control study. Cases were either symptomatic or asymptomatic HCWs with a positive SARS-CoV-2 polymerase chain reaction (PCR) test result between March 16 and May 21 of 2020. Adjusted odds ratios (aOR) were calculated by means of multivariable logistic regression. In addition, each subject was followed for 14 days to inform outcomes. RESULTS: One hundred thirty of 249 (52.2%) symptomatic HCWs had COVID-19; 10 were hospitalized but none died. Of 987 asymptomatic HCWs,37 (3.7%) were AC; 6 of the remaining 950 asymptomatic HCWs with a negative PCR test result were found to be presymptomatic COVID-19 cases the following 14 days. Nurses were more frequently present in the COVID-19 group (51.5% vs. 37.0%), but multivariable analysis rendered non-significant results. After adjustment for age, comorbidities, and working place, factors found to be associated with AC were: working in wards as a nurse (aOR = 9.19, 95% confidence interval [CI] = 1.05-80.22, p = 0.045), kitchen personnel (aOR = 4.09, 95% CI = 1.55-10.83, p = 0.005), and being a physician (aOR = 0.12, 95% CI = 0.03-0.54, p = 0.006). CONCLUSIONS: HCW category was the predominant factor associated with AC of SARS-CoV-2 in this study.

Preprint in English | medRxiv | ID: ppmedrxiv-20117994


BackgroundThere is still no specific treatment strategies for COVID-19 other than supportive management. The potential biological benefits of ozonated autohemotherapy include reduced tissue hypoxia, decreased hypercoagulability, modulated immune function with inhibition of inflammatory mediators, improved phagocytic function, and impaired viral replication. ObjectiveTo determine the impact of the use of ozonated blood on time to clinical improvement in patients with severe COVID-19 pneumonia. DesignA Quasi-Randomized Controlled Trial determined by admittance to the hospital based on bed availability. SettingInternal Medicine ward at Policlinica Ibiza Hospital, Spain. ParticipantsEighteen patients with COVID-19 infection (laboratory confirmed) severe pneumonia admitted to hospital between 20th March and 19th April 2020. The mean age of the cohort was 68 years-old and 72% (n=13) were male. InterventionPatients admitted to the hospital during the study period were pre-randomized to different beds based on bed availability. Depending on the bed the patient was admitted, the treatment was ozone autohemotherapy or standard treatment. Patients in the therapy arm received ozonated blood twice daily starting on the day of admission for a median of four days. Each treatment involved administration of 200 mL autologous whole blood enriched with 200 mL of oxygen-ozone mixture with a 40 g/mL ozone concentration. Main OutcomesThe primary outcome was time from hospital admission to clinical improvement, which was defined as either hospital discharge or a two-point improvement in clinical status measured on a six-point ordinal scale. Secondary outcomes were clinical improvement measured on the 7th, 14th and 28th day after admission, as well as time to a two-fold reduction in concentrations of C-reactive protein, ferritin, D-dimer and lactate dehydrogenase. ResultsNine patients (50%) received ozonated autohemotherapy beginning on the day of admission. Ozonated autohemotherapy was associated with shorter time to clinical improvement (median [IQR]), 7 days [6-10] vs 28 days [8-31], p=0.04) and better outcomes at 14-days (88.8% vs 33.3%, p=0.01). In risk-adjusted analyses, ozonated autohemotherapy was associated with a shorter mean time to clinical improvement (-11.3 days, p=0.04, 95% CI -22.25 to -0.42). ConclusionOzonated autohemotherapy was associated with a significantly shorter time to clinical improvement in this quasi-randomized controlled trial. Given the small sample size and study design, these results require evaluation in larger randomized controlled trials.