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1.
J Trauma Acute Care Surg ; 2022 May 20.
Article in English | MEDLINE | ID: covidwho-2191225

ABSTRACT

BACKGROUND: The impact of the COVID-19 pandemic on pediatric injury, particularly relative to a community's vulnerability, is unknown. The objective of this study was to describe the change in pediatric injury during the first 6 months of the COVID-19 pandemic compared to prior years, focusing on intentional injury relative to the Social Vulnerability Index (SVI). METHODS: All patients <18 years meeting inclusion criteria for the National Trauma Data Bank between 1/1/2016 and 9/30/2020 at 9 Level 1 Pediatric Trauma Centers were included. The COVID cohort (children injured in the first 6 months of the pandemic) were compared to an averaged Historical cohort (corresponding dates, 2016-2019). Demographic and injury characteristics, and hospital-based outcomes were compared. Multivariable logistic regression was used to estimate the adjusted odds of intentional injury associated with SVI, moderated by exposure to the pandemic. Interrupted time series analysis with autoregressive integrated moving average modeling was used to predict expected injury patterns. Volume trends and observed vs expected rates of injury were analyzed. RESULTS: 47,385 patients met inclusion criteria, with 8,991 treated in 2020 and 38,394 treated in 2016-2019. The COVID cohort included 7,068 patients and the averaged Historical cohort included 5,891 patients (SD 472), indicating a 20% increase in pediatric injury (p = 0.031). Penetrating injuries increased (722(10.2%) COVID vs 421(8.0%) Historical, p < 0.001), specifically firearm injuries (163(2.3%) COVID vs. 105(1.8%) Historical, p = 0.043). Bicycle collisions (505(26.3%) COVID vs. 261(18.2%) Historical, p < 0.001) and collisions on other land transportation (e.g. all-terrain vehicles) (525(27.3%) COVID vs. 280(19.5%) Historical, p < 0.001) also increased. Overall, SVI was associated with intentional injury (OR 7.9, 95% CI 6.5-9.8), a relationship which increased during the pandemic. CONCLUSIONS: Pediatric injury increased during the pandemic across multiple sites and states. The relationship between increased vulnerability and intentional injury increased during the pandemic. LEVEL OF EVIDENCE: III, Prognostic and Epidemiologic Study.

2.
Revista Medica de Chile ; 150(6):764-773, 2022.
Article in Spanish | Scopus | ID: covidwho-2201467

ABSTRACT

Background: COVID-19 confinement measures in the population affected the quality of life and sleep. Aims: To determine if confinement is associated with a lower quality of life and sleep. Subjects and Methods: A self-reported survey including questions about type of confinement, time spent in front of a screen, the international physical activity questionnaire (IPAQ), the Sleep Self Report questionnaire and the SF-36 quality of life survey, was answered by 621 Chilean university students. Results: Confined and not confined respondents spent a great amount of time in front of a screen, in sedentary activities and sleeping > 8 or < 6 hours per day. Those who were in confinement reported having a poorer quality of sleep and quality of life compared to those who were not in confinement. Those who required mandatory confinement for suspected COVID-19 had the worst quality of sleep and quality of life. Conclusions: University students had sedentary lifestyles regardless of the type of confinement. Those who were in confinement, especially for suspected COVID-19 infection, had the worst quality of sleep and quality of life. © 2022 Sociedad Medica de Santiago. All rights reserved.

3.
Pathogens ; 12(2):169, 2023.
Article in English | MDPI | ID: covidwho-2200592

ABSTRACT

Many rigorous studies have shown that early childhood infections leave a lasting imprint on the immune system. The understanding of this phenomenon has expanded significantly since 1960, when Dr. Thomas Francis Jr first coined the term 'original antigenic sin';, to account for all previous pathogen exposures, rather than only the first. Now more commonly referred to as 'immune imprinting';, this effect most often focuses on how memory B-cell responses are shaped by prior antigen exposure, and the resultant antibodies produced after subsequent exposure to antigenically similar pathogens. Although imprinting was originally observed within the context of influenza viral infection, it has since been applied to the pandemic coronavirus SARS-CoV-2. To fully comprehend how imprinting affects the evolution of antibody responses, it is necessary to compare responses elicited by pathogenic strains that are both antigenically similar and dissimilar to strains encountered previously. To accomplish this, we must be able to measure the antigenic distance between strains, which can be easily accomplished using data from multidimensional immunological assays. The knowledge of imprinting, combined with antigenic distance measures, may allow for improvements in vaccine design and development for both influenza and SARS-CoV-2 viruses.

4.
British Journal of Pharmacology ; 16:16, 2022.
Article in English | MEDLINE | ID: covidwho-2192440

ABSTRACT

BACKGROUND AND PURPOSE: Neutrophil overstimulation plays a crucial role in tissue damage during severe infections. As pathogen-derived neuraminidase (NEU) stimulate neutrophils, we investigated whether host NEU can be targeted to regulate neutrophil dysregulation observed in severe infections.

5.
Critical Care Medicine ; 51(1 Supplement):536, 2023.
Article in English | EMBASE | ID: covidwho-2190660

ABSTRACT

INTRODUCTION: Chronic kidney disease (CKD) is an important risk factor for severe COVID-19 disease associated with increased intensive care unit (ICU) admission and mortality. Studies demonstrate an increased mortality rate among advancing CKD stages in patients without COVID-19 infection. However, it is unknown whether a graded association exists between the stages of CKD and COVID-19 mortality. We aim to compare the rates of ICU admission, mechanical ventilation (MV), and survival amongst COVID-19 patients with Stage IIIb -V CKD. METHOD(S): We conducted a retrospective cohort study on non-dialysis adults with Stages IIIb, IV, and V CKD without previous renal transplant hospitalized for COVID-19 infection in a community hospital. Patients were categorized into two groups, Stage IIIb CKD and Stages IV&V CKD, based on their pre-admission glomerular filtration rate (GFR 30-44ml/ min vs < 30ml/min). The primary endpoints were rates of ICU admission, MV, non-invasive mechanical ventilation (NIMV), and survival. The Mann-Whitney U test for continuous variables and the chi-square test for categorical variables were used for analysis. RESULT(S): We screened 228 patients and 153 met the inclusion criteria. Baseline demographics were distributed equally between the two groups. There were statistically significant differences in the ICU admission rate (45.2% vs 25.3%,p-0.01), MV rate (37.1% vs 16.5%,p-0.004) and NIMV rate (50% vs 28.6%,p-0.007) in patients with Stage IIIb versus Stages IV&V CKD respectively. However, there was no significant difference in the survival rates (79.1% vs 67.7%,p-0.1128) between the two groups. CONCLUSION(S): The association between reduced baseline eGFR and increased risk of severe COVID-19 infection has been established with multiple studies evaluating the prognostic impact of pre-existing CKD in patients with COVID-19. Our study illustrates the greater incidence of adverse outcomes, such as ICU admission rate, MV rate, and NIMV rate, in patients with Stages IV&V CKD versus Stage IIIb CKD. With recent guidelines recommending management of COVID-19 infection based on the presence of risk factors, these results will aid in risk stratification among CKD patients with COVID-19, and encourage future prospective studies to explore disease-modifying treatments for the vulnerable CKD population.

6.
Open Forum Infectious Diseases ; 9(Supplement 2):S171-S172, 2022.
Article in English | EMBASE | ID: covidwho-2189562

ABSTRACT

Background. The clinical use of inflammatory markers soared during the COVID-19 pandemic. Though studies have shown C-reactive protein (CRP) to predict mechanical ventilation (MV) in patients with COVID-19, its utility is unknown in patients with chronic kidney disease (CKD), who have elevated baseline CRP levels due to chronic inflammation and reduced renal clearance of inflammatory cytokines. Our aim was to assess the association of inflammatory markers like CRP, ferritin, LDH, D dimer, and MV rate in patients with stages IIIb-V CKD and COVID-19. Methods. We conducted a cross-sectional study on inpatients in a community hospital from 12/1/19 to 1/1/22 with COVID-19 and stages IIIb-V CKD without a previous renal transplant. Primary endpoints were invasive MV(IMV) rates, noninvasive MV(NIMV) rates, and no MV. Statistical analyses used unpaired t-test for continuous variables and chi-square analysis for categorical variables. Cutoffs for variables were CRP 100 mg/L, ferritin 530ng/ml, D-dimer 0.5mg/L and LDH 590 U/L. Univariate analysis and Area under curve (AUC-ROC) between the covariates and outcomes were computed. Results. 290 patients were screened, and 118 patients met inclusion criteria. CRP, D dimer, and ferritin were significantly different among the three groups. On univariate analysis for IMV, CRP had an OR 5.44;ferritin, OR 2.8;LDH, OR 7.7;D-dimer, OR 3.9, WBC count, OR 4.2 (p< 0.05). Admission CRP level was 0.747 for the IMV group (AUC-ROC, sensitivity 80.8%, specificity 50%) and 0.663 for the NIMV group (AUC-ROC, sensitivity 69.2%, specificity 53%) Conclusion. Our results illustrate a positive correlation between CRP, ferritin, and D-dimer levels and MV and NIMV rates. The ROC demonstrates a good sensitivity for CRP levels in detectingMVthereby emphasizing the utility of these biomarkers as good predictive markers in COVID-19 patients with CKD. With increasing use of inflammatory markers to prognosticate disease severity in COVID, the applicability of these markers in different populations should be investigated. A similar pattern of elevated inflammatory markers predicting the rate of MV was found in patients with stages IIIb-V CKD. This may be because of the greater magnitude of increased inflammation due to COVID-19 itself compared with increased inflammation due to CKD alone.

7.
Journal of Infectious Diseases ; 226(12):2045-2046, 2022.
Article in English | Academic Search Complete | ID: covidwho-2189155

ABSTRACT

During my years as I JID i editor, we have missed no issues, have had no scandals, and have published high-quality scientific research articles in all areas of infectious diseases. This issue marks the end of my 20 years as editor of I The Journal of Infectious Diseases (JID). i Cindy Sears, a superb scientist, clinician, and academician, will become the new editor in 2023, and she has assembled an outstanding group of deputy and associate editors to help her. In addition to outstanding original research articles over the past 20 years, we have also published many JID supplements on important topics in infectious diseases. [Extracted from the article]

8.
ACS Appl Bio Mater ; 6(1):238-245, 2023.
Article in English | MEDLINE | ID: covidwho-2185490

ABSTRACT

Since the onset of the SARS-CoV-2 pandemic, the world has witnessed over 617 million confirmed cases and more than 6.54 million confirmed deaths, but the actual totals are likely much higher. The virus has mutated at a significantly faster rate than initially projected, and positive cases continue to surge with the emergence of ever more transmissible variants. According to the CDC, and at the time of this manuscript submission, more than 77% of all current US cases are a result of the B.5 (omicron). The continued emergence of highly transmissible variants makes clear the need for more effective methods of mitigating disease spread. Herein, we have developed an antimicrobial fabric capable of destroying a myriad of microbes including betacoronaviruses. We have demonstrated the capability of this highly porous and nontoxic metal organic framework (MOF), gamma-CD-MOF-1, to serve as a host for varied-length benzalkonium chlorides (BACs;active ingredient in Lysol). Molecular docking simulations predicted a binding affinity of up to -4.12 kcal.mol(-1), which is comparable to that of other reported guest molecules for this MOF. Similar Raman spectra and powder X-ray diffraction patterns between the unloaded and loaded MOFs, accompanied by a decrease in the Brunauer-Emmett-Teller surface area from 616.20 and 155.55 m(2) g(-1) respectively, corroborate the suggested potential for pore occupation with BAC. The MOF was grown on polypropylene fabric, exposed to a BAC-loading bath, washed to remove excess BAC from the external surface, and evaluated for its microbicidal activity against various bacterial and viral classes. Significant antimicrobial character was observed against Pseudomonas aeruginosa, Staphylococcus aureus, Escherichia coli, bacteriophage, and betacoronavirus. This study shows that a common mask material (polypropylene) can be coated with BAC-loaded gamma-CD-MOF-1 while maintaining the guest molecule's antimicrobial effects.

9.
Schmalenbach Journal of Business Research ; 74(4):497-535, 2022.
Article in English | Scopus | ID: covidwho-2175403

ABSTRACT

The ongoing COVID-19 pandemic triggered a global crisis affecting the work and partially the existence of businesses, governments, administrations and nonprofit organizations (NPOs). The latter not only faced severe challenges themselves, but also play(ed) a major role in fighting the pandemic, especially those offering services in social and health care. Maintaining service delivery under pandemic conditions to serve the often vital needs of clients requires (organizational) resilience. This concept generally relates to the ability to withstand adversity, to adapt in a turbulent environment and respond to (disruptive) change. Based on a qualitative content analysis of 33 interviews with nonprofit executives, this paper explores the impact of the pandemic on Austrian NPOs active in health and social care in terms of contextual challenges faced. Our study contributes to (nonprofit) resilience research and extreme context research literature as it illustrates how NPOs coped with this disruptive extreme context. Our findings show which resilience mechanisms (i.e. all kinds of resilient behavior, resources and capabilities) were helpful in overcoming pandemic challenges and getting through these hard times. © 2022, The Author(s).

10.
EAI/Springer Innovations in Communication and Computing ; : 191-204, 2023.
Article in English | Scopus | ID: covidwho-2173688

ABSTRACT

From an increasingly early age, girls and boys handle technology, and digital education must become an essential part of the training of young people. The European Union has recognized that it is urgent to strengthen training in digital competence throughout Europe so that Member States can recover from the crisis caused by the Covid-19 pandemic, in addition to building the foundations for a more ecological and digital Europe. In line with European policies, Spain has designed a national plan for digital skills, providing a strategic framework aligned with the 2030 agenda and the Sustainable Development Goals (SDGs). From the private sector, digital education initiatives have also been proposed. Thus, the Vodafone Spain Foundation has designed and is carrying out an educational program for the development of digital competence. In this educational program, gamification is part of both the training activities and the evaluation process, and in both cases, it is understood as a strategy aimed to promote engagement to the training process. This chapter presents the educational program DigiCraft for the development of digital competence and the evaluation process designed to verify their acquisition, in which the game has a fundamental pedagogical role. © 2023, The Author(s), under exclusive license to Springer Nature Switzerland AG.

12.
J Infect Dis ; 226(11): 1861-1862, 2022 Nov 28.
Article in English | MEDLINE | ID: covidwho-2152027
13.
Radical Teacher ; 124:13-23, 2022.
Article in English | Scopus | ID: covidwho-2164080

ABSTRACT

The COVID-19 pandemic, coupled with the ensuing lockdown and political turmoil, ruptured many young people's experiences and well-being, particularly students who face additional marginalization due to systemic oppression. A national survey conducted by the Trevor Project (2021) found that nearly 70% of LGBTQ youth noted that their health was "poor” most or all of the time during the COVID-19 pandemic. Factors contributing to this deterioration include LGBTQ youth being isolated from the supportive communities formed at school, lacking access to social services provided by schools, and being quarantined with family members who were unsupportive (Cohen, 2021;Valencia, 2020). These fissures in support and resource structures curtailed potentially affirming and integral education, social, and emotional experiences, particularly for LGBTQ youth who thrived in traditional schooling settings. However, it is also important to note that even prior to the COVID-19 pandemic, many schools were not idealized institutions for LGBTQ youth. K-12 schools, situated in the broader socio-political landscape of the United States, are bastions of homo-, trans-, and queerphobia (Mayo, 2014). Still, many LGBTQ young people employed resilience and ingenuity to create affirming and loving social circles, which were thus interrupted by restrictions, trauma, and isolation during the pandemic. As LGBTQ educators we sought to co-create an online community that could reflect the brilliance and joy of LGBTQ youth during the 2020-2021 school year. Through both our own experiences and the research, we know that LGBTQ youth find ways to construct community through online avenues, even when said avenues are limited and flawed, such as Tumblr (Cavalcante, 2019;Haimson, et al., 2021;Wargo, 2017). Building on our experiences as secondary English language arts teachers, we constructed a national online book club dedicated to reading, analyzing, and celebrating LGBTQ young adult literature with LGBTQ youth. After a summer of planning, we launched the online book club that resulted in over 125 secondary students from across the United States (and some international students) joining us for a year to engage in readings of Abdi Nazemian's Like a Love Story (2019), Dean Atta's Black Flamingo (2019), Gabby Rivera's Juliet Takes a Breath (2016), and Mark Oshiro's Anger is a Gift (2018). This article details how we structured a community of readers who worked to analyze young adult literature through intersectional and anti-oppressive lenses (Blackburn & Smith, 2010;Durand, 2015;Herman-Wilmarth & Ryan, 2015), deepen their critical consciousness relating to contemporary LGBTQ socio-political topics (Kelly & Currie, 2020), and leveraged social media and online avenues to construct community that expanded the boundaries of school hallways (Lucero, 2017;Mayo, 2014). Collectively, we seek to illustrate how LGBTQ+ communities (and queer pedagogies) can flourish and develop outside the limitations of K-12 institutions. © University Library System, University of Pittsburgh.

15.
12th International Conference on Virtual Campus, JICV 2022 ; 2022.
Article in English | Scopus | ID: covidwho-2161445

ABSTRACT

Advances in the Knowledge Society and the evolution of Information and Communication Technologies (ICTs) have led to great advances in different spheres of action. Regarding the academic, ICTs have enabled important transformations in teaching and learning processes. In the academic year 2021-22, two years after of the beginning of the COVID pandemic, the Spanish Ministry of Universities, and the Crue Spanish Universities, agree to carry out the safe face-to-face format that implies the implementation of blended learning or b-learning or hybrid learning. This article describes the perceptions about the use of Studium as a blended learning tool that 143 Spanish University students. An adapted version of the last section of the Innovative Methodology Assessment instrument by García et al. (2008) is used, which is designed through Google Forms. The results show that the students consider that the use of Studium in the subject has facilitated the acquisition of new knowledge, while it has allowed them to be more autonomous and responsible for their learning and work in an appropriate way. In addition, they state that they feel comfortable with such use. And they also state that it is very likely that, in other countries, they are using said web tool. Despite all the above, they also affirm that the use of this tool in the teaching and learning processes requires a lot of time, and that, in a certain way, it makes it difficult to acquire teamwork skills. Considering these results, the academic implications of using the institutional Moodle, Studium, in the teaching and learning processes of Higher Education to implement the new approach, blended learning, considering gender and the degree. © 2022 IEEE.

16.
The Lancet Regional Health - Americas ; 18:100411, 2023.
Article in English | ScienceDirect | ID: covidwho-2159508

ABSTRACT

Summary Background The ongoing coronavirus diseases 2019 (COVID-19) pandemic with its numerous variants of concern has shown the need to have a robust and complete global infectious diseases genomic surveillance network worldwide. Various clinical and research institutions have stepped up to perform SARS-CoV-2 sequencing thus enhancing the understanding of this virus' global evolution. However, given that genomic sequencing capacities and capabilities are not available in every region or country, significant gaps exist, which lead to geographic blind spots. One such region is the Caribbean. This paper measures the Caribbean region's SARS-CoV-2 genomic sequencing capacity and highlights the need to improve further regional genomics surveillance capacities and capabilities, which are essential for efficient health interventions for infectious diseases. Methods A map showing SARS-CoV-2 sequences available for each Caribbean Island was constructed using SARS-CoV-2 genomic, epidemiological and populational data obtained from GISAID, the World Health Organization, the United Nations, and the World Bank. The number of reported SARS-CoV-2 cases and the proportion of cases sequenced in each Caribbean Island was then analysed by the Gross Domestic Product per capita and political status. Findings As of August 6, 2022, the number of SARS-CoV-2 sequences from the Caribbean are underrepresented with only 40,190 (1.07%) of the over 3.76 million documented cases sequenced, which is further exacerbated by a disparity based not only on the country's income but also on its political status (sovereign country versus dependent or integrated) and accessibility to sequencing technologies. There are a limited number of sequencing centres based in the Caribbean islands with the majority located on the American and European continents. Using mobile sequencing technologies while concomitantly investing in data analysis training could lead to greater and more sustainable coverage. Interpretation Considering the Caribbean region's dispersed heterogeneous populations, varying political regimes, and resource-constrained healthcare systems, further development of local next-generation sequencing capacity and capabilities in the Caribbean region is needed to achieve global public health goals. Funding No funding source was required for this study.

17.
Research and Practice in Thrombosis and Haemostasis Conference ; 6(Supplement 1), 2022.
Article in English | EMBASE | ID: covidwho-2128176

ABSTRACT

Background: Cerebral venous thrombosis (CVT) is a major cause of stroke in young adults. Is more frequent in women, it may appear related to pregnancy or the use of hormonal contraceptives. Its symptoms are nonspecific, often with a normal neurological examination. Its diagnosis is based on imaging tests and in most cases, if treatment is started early, the prognosis may be favorable. Aim(s): Describe the characteristics of CVT in patients that we have had in our clinic. Method(s): We compiled data from patients with CVT followed up in our hemostasis consultation in the last 6 years. Patient data were collected through hospital medical records. Result(s): We have a series of 15 cases, most of them women (73.3%). The average age of the series is 38.6 years (range from newborn to 64 years). The most frequent symptoms were epileptic seizures in 40% and headache in 33.3%. In 45.5% of women, CVT was related to pregnancy or the puerperium, and in 27.3% of the women it was associated with taking oral contraceptives. Thrombophilia (genetic or acquired) has been found to be involved in 33.3% of cases. The remaining cases were associated with breast cancer (1), trauma (1), severe anemia (1), and SARS-CoV vaccines (1). In two cases (13.3%) decompressive neurosurgery was required. In two cases (13,3%), direct oral anticoagulant (apixaban and dabigatran) were used. In 60% of cases anticonvulsant treatment was associated. In 40% of cases, the evolution was very favorable without sequelae, recurrent headache was found in 53,3% of cases. Conclusion(s): CVT is a rare but important cause of stroke in young adults. CVT it is not easy to diagnose, partly due to its relative rarity, its multiple and various clinical manifestations and interpret correct brain imaging. We must keep it in mind to avoid delay in diagnosis and treatment. (Table Presented).

18.
Int J Mol Sci ; 23(22)2022 Nov 14.
Article in English | MEDLINE | ID: covidwho-2115955

ABSTRACT

Recently, a recombinant SARS-CoV-2 lineage, XD, emerged that harbors a spike gene that is largely derived from the Omicron variant BA.1 in the genetic background of the Delta variant. This finding raised concerns that the recombinant virus might exhibit altered biological properties as compared to the parental viruses and might pose an elevated threat to human health. Here, using pseudotyped particles, we show that ACE2 binding and cell tropism of XD mimics that of BA.1. Further, XD and BA.1 displayed comparable sensitivity to neutralization by antibodies induced upon vaccination with BNT162b2/Comirnaty (BNT) or BNT vaccination followed by breakthrough infection. Our findings reveal important biological commonalities between XD and Omicron BA.1 host cell entry and its inhibition by antibodies.


Subject(s)
COVID-19 , Spike Glycoprotein, Coronavirus , Humans , Spike Glycoprotein, Coronavirus/genetics , SARS-CoV-2/genetics , Viral Envelope Proteins/genetics , BNT162 Vaccine , Membrane Glycoproteins/metabolism
19.
Cell Rep ; 39(5): 110754, 2022 05 03.
Article in English | MEDLINE | ID: covidwho-2113939

ABSTRACT

Rapid spread of SARS-CoV-2 variants C.1.2 and B.1.621 (Mu variant) in Africa and the Americas, respectively, as well as a high number of mutations in the viral spike proteins raised concerns that these variants might pose an elevated threat to human health. Here, we show that C.1.2 and B.1.621 spike proteins mediate increased entry into certain cell lines but do not exhibit increased ACE2 binding. Further, we demonstrate that C.1.2 and B.1.621 are resistant to neutralization by bamlanivimab but remain sensitive to inhibition by antibody cocktails used for COVID-19 therapy. Finally, we show that C.1.2 and B.1.621 partially escape neutralization by antibodies induced upon infection and vaccination, with escape of vaccine-induced antibodies being as potent as that measured for B.1.351 (Beta variant), which is known to be highly neutralization resistant. Collectively, C.1.2 and B.1.621 partially evade control by vaccine-induced antibodies, suggesting that close monitoring of these variants is warranted.


Subject(s)
COVID-19 , SARS-CoV-2 , Antibodies, Monoclonal, Humanized , Antibodies, Neutralizing , Antibodies, Viral , COVID-19 Vaccines , Humans , Spike Glycoprotein, Coronavirus , Vaccination
20.
Jimenez, S.; Miro, O.; Alquezar-Arbe, A.; Pinera, P.; Jacob, J.; Llorens, P.; Garcia-Lamberechts, E. J.; Martin-Sanchez, F. J.; Del Castillo, J. G.; Burillo-Putze, G.; Martin, A.; Grima, M. L. L.; Gomez, M. A. J.; Millan, J.; Lazaro, L. S.; Espinosa, B.; Paya, A. B.; Noceda, J.; Cano, M. J. C.; Serra, R. S.; Bayarri, M. J. F.; Suarez, F. J. S.; Tejera, M. G.; Porrino, J. M. M.; Maestre, M. R.; Melendez, N.; Albero, P. B.; Escolano, E. R.; Manrique, K. J. A.; Del Rio, R.; Mestre, A. M.; Garcia, C. P.; Amador, P. S.; Aznar, J. V. B.; Lopez, J. L. R.; Ponce, M. C.; Belda, M. B. R.; Fernandez, E. D.; Valero, C. C.; Gimenez, L. M.; Gomez, A. P.; Bellver, E. G.; Rizzi, M.; Suarez, C. C.; Cardozo, C.; Llopis-Roca, F.; Roset-Rigat, A.; Boter, N. R.; Rovira, M. A.; Tost, J.; Tejedo, A. A.; Lorenzo, I. C.; Palau-Vendrell, A.; Tur, R. G.; Munoz, M. A.; Ferrer, E. S.; Garcia, L. L.; Mojarro, E. M.; Jimenez, B. S. A.; Huerta, A.; Fragiel, M.; Quiros, A. M.; Del Val, E. M.; Del Arco Galan, C.; Jimenez, G. F.; Garate, R. T.; Borrego, B. V.; Arias, A. S.; Cabezas, V. P.; Aviles, R. M.; Gonzalez, S. R.; Ramos, M. E. B.; Alonso, M. A.; Martin-Borregon Bendito, P.; Aguado, A. C.; Martin, S. G.; Somohano, F. V.; Lopez-Laguna, N.; Panadero, R. P.; De Frutos, M. F.; Robledo, F. D.; Madrigal, A. A.; Castaneda, A. B.; Diez, M. P. L.; Izquierdo, R. L.; Ruperez, I. G.; Chaib, F. B.; Abdelkader, I. S. M.; Rafael, I. R.; Tornero, A. P.; Soriano, J. J. C.; Perez, E. M.; Urbano, C. A.; Soto, A. B. G.; Garcia, J. P.; De Simon Almela, A. F.; Lopez, R. C.; Diaz, J. J. L.; Vera, M. T. M.; Calveiro, R. R.; Lucas-Imbernon, F. J.; Moreno, M. R.; Martinez, F. G.; Olmeda, D. M.; Juarez, R.; Hernandez, P. E.; Rodriguez, M. E.; Monzo, J. P.; Gonzalez, N. C.; Herrera, D. M. V.; Bautista, B. M. M.; Alvarez, L. A.; Hevia, M. D. R. C.; Motto, E. Q.; Garcia, N. T.; Diaz, N. M.; Mercader, M. P. O.; De Lobera, N. R.; Amez, J. M. F.; Entrala, B. A..
Emergencias ; 34(5):369-376, 2022.
Article in Spanish | EMBASE | ID: covidwho-2111934

ABSTRACT

Objectives. To define quality of care indicators and care process standards for treating patients with COVID-19 in hospital emergency departments (EDs), to determine the level of adherence to standards during the first wave in 2020, and to detect factors associated with different levels of adherence. Methods. We selected care indicators and standards by applying the Delphi method. We then analyzed the level of adherence in the SIESTA cohort (registered by the Spanish Investigators in Emergency Situations Team). This cohort was comprised of patients with COVID-19 treated in 62 Spanish hospitals in March and April 2020. Adherence was compared according to pandemic-related ED caseload pressure, time periods during the wave (earlier and later), and age groups. Results. Fourteen quality indicators were identified. Three were adhered to in less than 50% of the patients. Polymerase chain reaction testing for SARS-CoV-2 infection was the indicator most often disregarded, in 29% of patients when the caseload was high vs 40% at other times (P <.001) and in 30% of patients in the later period vs 37% in the earlier period (P =.04). Adherence to the following indicators was better in the later part of the wave: Monitoring of oxygen saturation (100% vs 99%, P =.035), electrocardiogram monitoring in patients treated with hydroxychloroquine (87% vs 65%, P <.001), and avoiding of lopinavir/ritonavir treatment in patients with diarrhea (79% vs 53%, P <.001). No differences related to age groups were found. Conclusions. Adherence to certain quality indicators deteriorated during ED treatment of patients with COVID-19 during the first wave of the pandemic. Pressure from high caseloads may have exacerbated this deterioration. A learning effect led to improvement. No differences related to patient age were detected. Copyright © 2022, Saned. All rights reserved.

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