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1.
Infect Dis Ther ; 2022.
Article in English | PubMed | ID: covidwho-1813898

ABSTRACT

INTRODUCTION: Increased mortality has been reported in the Latin American population. The objective is to compare the clinical characteristics and outcome of Latin American and Spanish populations in a cohort of patients hospitalized with COVID-19 during the first year of the pandemic. METHODS: We retrospectively analysed all the Latin American patients (born in South or Central America) hospitalized in our centre from February 2020 to February 2021 and compared them with an age- and gender-matched group of Spanish subjects. Variables included were demographics, co-morbidities, clinical and analytical parameters at admission and treatment received. The primary outcomes were ICU admission and mortality at 60 days. A conditional regression analysis was performed to evaluate the independent baseline predictors of both outcomes. RESULTS: From the 3216 patients in the whole cohort, 216 pairs of case-controls (Latin American and Spanish patients, respectively) with same age and gender were analysed. COPD was more frequent in the Spanish group, while HIV was more prevalent in the Latin American group. Other co-morbidities showed no significant difference. Both groups presented with similar numbers of days from symptom onset, but the Latin American population had a higher respiratory rate (21 vs. 20 bpm, P = 0.041), CRP (9.13 vs. 6.22 mg/dl, P = 0.001), ferritin (571 vs. 383 ng/ml, P = 0.012) and procalcitonin (0.10 vs. 0.07 ng/ml, P = 0.020) at admission and lower cycle threshold of PCR (27 vs. 28.8, P = 0.045). While ICU admission and IVM were higher in the Latin American group (17.1% vs. 13% and 9.7% vs. 5.1%, respectively), this was not statistically significant. Latin American patients received remdesivir and anti-inflammatory therapies more often, and no difference in the 60-day mortality rate was found (3.2% for both groups). CONCLUSION: Latin American patients with COVID-19 have more severe disease than Spanish patients, requiring ICU admission, antiviral and anti-inflammatory therapies more frequently. However, the mortality rate was similar in both groups.

2.
2021 IEEE 13th International Conference on Humanoid, Nanotechnology, Information Technology, Communication and Control, Environment, and Management, HNICEM 2021 ; 2021.
Article in English | Scopus | ID: covidwho-1788672

ABSTRACT

In the Philippines, contact-tracing is done in the conventional method where people fill-up health-declaration forms. Proper physical distancing is not followed, especially in public places. This study is focused on concerns involving the conventional contact tracing and physical distancing in Pamantasan ng Cabuyao. Developed using modified incremental-prototyping methodology. The objective is to develop module device with ranging position, triggered when one-meter distance is compromised and physical distancing notification. Included a web-based application interface for contact-tracing where the administrator can update the status and registration of the users. Utilized block-chain technology as storage for the users' information. The device is developmentally-designed, implemented and evaluated. Based on the series of testing, the device provides notification through blinking light, and set-off to exchange identifications. Users' information is secured through the Block-chain. When a user is reported to be COVID-19 positive, all the users who have been in contact, will be alerted via text message. © 2021 IEEE.

3.
2021 IEEE 13th International Conference on Humanoid, Nanotechnology, Information Technology, Communication and Control, Environment, and Management, HNICEM 2021 ; 2021.
Article in English | Scopus | ID: covidwho-1788667

ABSTRACT

Wearing facemasks, face shields and social distancing are some of health protocols that are being imposed to lessen the risk of viral transmission specifically COVID 19. All establishments here in the Philippines build their own sanitation booths to ensure virus prevention. This study aims to address the issues regarding the use of chemical disinfectants and manually placing them in sanitation booths, and the ineffective manual ways of sanitizing individuals. This study is a design project adopting the developmental type of research method. Hypochlorous acid (HOCL) has a lot of potential as a disinfectant. In an electrolysis chamber with dilute salt and distilled water, HOCL can be made. The researchers design a device to automate the manufacturing of HOCL, which will be use as disinfectant, and automatically sanitize individuals with a safer and non-toxic disinfectant. The researchers prepared questionnaires to assess the acceptability of the device. The statistical tool used in the interpretation of data is weighted arithmetic mean. The major finding of this study is the ability of the device to convert distilled water and salt into disinfectant solution with the electrolysis process utilized, the duration of the process that will optimally convert it is 40 minutes, with accurate reading of analog pH sensor and lessen the exposure to each individual through the automation of the sanitation booth. For that reason, the researchers conclude that this design project provides a way to ensure virus prevention using automatic sanitation booth with disinfectant (HOCL) solution that offers more benefits over traditional sanitation methods. The overall acceptability rating of the design project is 4.46, interpreted as Very Good which shows that the device has high satisfaction. © 2021 IEEE.

4.
Open Forum Infectious Diseases ; 8(SUPPL 1):S369-S370, 2021.
Article in English | EMBASE | ID: covidwho-1746461

ABSTRACT

Background. There are few real-world data on the use of remdesivir (RDV) looking at timing of initiation in relation to symptom onset and severity of presenting disease. Methods. We conducted multi-country retrospective study of clinical practice and use of RDV in COVID-19 patients. De-identified medical records data were entered into an e-CRF. Primary endpoints were all-cause mortality at day 28 and hospitalization duration. We assessed time from symptom onset to RDV start and re-admission. We included adults with PCR-confirmed symptomatic COVID-19 who were hospitalized after Aug 31, 2020 and received at least 1 dose of RDV. Descriptive analyses were conducted. Kaplan-Meier methods were used to calculate the mortality rate, LogRank test to compare groups defined by severity of disease. Competing risk regression with discharge and death as competing events was used to estimate duration of hospitalization, and Gray's test to compare the groups. Results. 448 patients in 5 countries (12 sites) were included. Demographics are summarized (table) by 3 disease severity groups at baseline: no supplemental oxygen (NSO), low flow oxygen ≤6 L/min (LFO), and high-flow oxygen > 6L/min (HFO). No demographic differences were found between groups except for the higher percentage of cancer/chemotherapy patients in NSO group. Corticosteroids use was HFO 73.6%, LFO 62.7%, NSO 58.0%. Mortality rate was significantly lower in NSO, and LFO groups compared with HFO (6.2%, 10.2%, 23.6%, respectively;Fig1). Median duration of hospitalization was 9 (95%CI 8-10), 9 (8-9), 13 (10-15) days, respectively (Fig2). Median time from first symptom to RDV start was 7 days in all 3 groups. Patients started RDV on day 1 of hospitalization in HFO and LFO and day 2 on NSO groups. And received a 5 day course (median). Readmission within 28-days of discharge was < 5% and similar across all 3 groups. Conclusion. In this real-world cohort of COVID-19 positive hospitalized patients, RDV use was consistent across countries. RDV was started within a median of 7 days from symptom within 2 days of admission and given for a median of 5 days. Higher mortality rate and duration of hospitalization was seen in the HFO group and similar rates seen in the LFO and NSO groups. Readmission was consistently low across all 3 groups.

5.
Journal of Crohn's and Colitis ; 16:i228-i229, 2022.
Article in English | EMBASE | ID: covidwho-1722312

ABSTRACT

Background: In the last year, the severe adult respiratory syndrome coronavirus 2 (SARS-CoV-2) epidemic has spread rapidly around the world. The interactions between SARS-CoV-2 and inflammatory bowel disease (IBD) are so far not fully understood. In particular, no studies evaluated the potential role of SARS-CoV-2 on IBD course. Indeed, it is known that viral infections can be act as triggers for IBD flare and it is reasonable that the possible drug discontinuation during SARS-CoV-2 infection could in turn lead to an IBD flare. Methods: This was a prospective, observational case-control study. From March 11th 2020 to June 30th 2020 we enrolled IBD patients with proven SARS-Cov-2 infection (cases) and IBD patients without SARS-CoV-2 infection matched for sex, age, diagnosis, therapy and clinical activity (controls). Cases and controls were followed-up at least for 6 months. Differences between case and control group were tested for significance using the Students t test and Fishers test, as appropriate. A two-tailed p value < 0.05 was indicative of statistical significance. Results: 219 IBD patients (127 UC, 58.0%) with SARS-CoV-2 infection and 219 IBD patients without SARS-CoV-2 infection were enrolled. Table 1 shows baseline features of the population. Among the 122 cases in clinical remission at the time of viral infection, 28 (22.9%) showed a disease flare;this percentage was significantly higher than that observed in controls: 12/137 (8.8%)(p=0.0018). Among patients with disease flare, there were no significant differences between cases and controls group in terms of age (42.3 ± 16.0 vs. 43.1 ± 15.4 years, p=0.44), gender (female 45.7% vs. 48.2%, p= 0.54), use of biologic therapies (p=0.83) and UC or CD diagnosis (p=0.06). Biologic therapy was temporary withdrawn more significantly in cases than in controls (68/202, 33.6% vs. 14/204, 6.9%) (p<0.001) and overall biologic therapy discontinuation was significantly associated with disease flare (OR 2.56, 95% CI 1.026.41, p=0.04). Conclusion: IBD patients with SARS-CoV-2 infection have an increased risk to have a clinical recurrence in short-term in comparison with IBD patients without SARS-CoV-2 infection. This increased risk could be due to the viral infection and/or to the temporary discontinuation of biologic therapies, because of infection.

7.
Pneumon ; : 6, 2021.
Article in English | Web of Science | ID: covidwho-1551958

ABSTRACT

INTRODUCTION COVID-19 disproportionately impacts patients aged >= 80 years, yet few studies have focused on this population. We aimed to investigate the clinical characteristics and outcomes of very elderly patients with COVID-19 across three consecutive waves in Spain. METHODS We retrospectively evaluated very elderly patients admitted with COVID-19 to a university hospital in Barcelona, Spain, across the three first waves. Main outcomes were ICU admission and 30-day mortality. RESULTS From March 2020 to February 2021, 3105 patients diagnosed with COVID-19 were admitted. Of these, 655 (21%) were very elderly patients, 50% were female and median age was 86 (83;89) years. ICU admission and ICU-mortality rates were 11% and 42%, respectively;male sex, respiratory rate >= 25 breaths/min, LDH >= 337.5 U/L and C-reactive protein >= 11.5 mg/dL were significantly associated with ICU admission in the multivariable analysis. Overall, 30-day mortality was 34%. The ICU admission rate was significantly higher during the first wave compared to the third wave (16% vs 8%;p=0.009), whereas no significant differences in 30-day mortality were found between waves (p=0.107). CONCLUSIONS We observed an increase in the percentage of very elderly patients admitted to the ICU during the three first pandemic peaks. ICU admission more likely occurs in very elderly male patients with higher respiratory rate, with elevate LDH and C-reactive protein. Overall, our 30-day mortality rate was lower compared to other series globally.

8.
Research and Practice in Thrombosis and Haemostasis ; 5(SUPPL 2), 2021.
Article in English | EMBASE | ID: covidwho-1509004

ABSTRACT

Background : Previous reports describe high rates of venous thromboembolism (VTE) in critically ill COVID-19 patients. Consequently, intermediate and therapeutic doses anticoagulation have been used in clinical practice, potentially exposing patients to a higher risk of bleeding. Aims : To evaluate the rate of thrombosis, bleeding and mortality comparing prophylactic, intermediate or therapeutic doses in critically ill COVID-19 patients. Methods : All COVID-19 patients admitted to the intensive care unit of a tertiary hospital between March and April 2020 were included. Patients were categorized into three groups according to the highest anticoagulant dose received: prophylactic, intermediate and therapeutic. Incidence of VTE, bleeding and mortality were compared between groups. We performed two logistic multivariable regressions to test the association between VTE and bleeding with clinical characteristics and the anticoagulant regimen. Results : 201 patients were included. 78 (39%) received prophylactic, 94 (47%) intermediate and 29 (14%) therapeutic doses. There were no differences in VTE and mortality between groups. In contrast, bleeding events were more frequent in patients receiving therapeutic (31%) and intermediate (15%) doses than in those receiving prophylactic doses (5%) ( P < 0.001 and P < 0.05 respectively). Major bleedings were also more frequent in patients with anticoagulant doses ( P < 0.01). The anticoagulant dose was the strongest determinant for bleeding (odds ratio [OR] 2.4, 95% confidence interval (CI) 1.26-4.58, P = 0.008) but had no impact on VTE (OR 0.97, 95%CI 0.58-1.68, P = 0.92). Conclusions : Critically ill COVID-19 patients receiving intermediate or therapeutic doses of heparin appear to have a higher risk of bleeding without a decrease of VTE events and mortality.

9.
Rev Esp Quimioter ; 34(4): 337-341, 2021 Aug.
Article in English | MEDLINE | ID: covidwho-1317435

ABSTRACT

OBJECTIVE: The study aims to describe characteristics and clinical outcome of patients with SARS-CoV-2 infection that received siltuximab according to a protocol that aimed to early block the activity of IL-6 to avoid the progression of the inflammatory flare. METHODS: Retrospective review of the first 31 patients with SARS-CoV-2 treated with siltuximab, in Hospital Clinic of Barcelona or Hospital Universitario Salamanca, from March to April 2020 with positive polymerase-chain reaction (PCR) from a nasopharyngeal swab. RESULTS: The cohort included 31 cases that received siltuximab with a median (IQR) age of 62 (56-71) and 71% were males. The most frequent comorbidity was hypertension (48%). The median dose of siltuximab was 800 mg ranging between 785 and 900 mg. 7 patients received siltuximab as a salvage therapy after one dose of tocilizumab. At the end of the study, a total of 26 (83.9) patients had been discharged alive and the mortality rate was 16.1% but only 1 out of 24 that received siltuximab as a first line option (4%). CONCLUSIONS: Siltuximab is a well-tolerated alternative to tocilizumab when administered as a first line option in patients with COVID-19 pneumonia within the first 10 days from symptoms onset and high C-reactive protein.


Subject(s)
Antibodies, Monoclonal/therapeutic use , COVID-19/drug therapy , Aged , Antibodies, Monoclonal, Humanized/therapeutic use , C-Reactive Protein/analysis , COVID-19/mortality , Cytokine Release Syndrome/drug therapy , Cytokine Release Syndrome/etiology , Disease Progression , Female , Humans , Hypertension/complications , Interleukin-6/antagonists & inhibitors , Interleukin-6/blood , Male , Middle Aged , Retrospective Studies , Salvage Therapy , Treatment Outcome
10.
11.
Open Forum Infectious Diseases ; 7(SUPPL 1):S343-S344, 2020.
Article in English | EMBASE | ID: covidwho-1185918

ABSTRACT

Background: Remdesivir (RDV) has been shown to shorten recovery time and was well tolerated in patients with severe COVID-19. Hydroxychloroquine (HQN) is an experimental treatment for COVID-19. Effects of coadministration of HQN with RDV have not been studied and are relevant given the long half-life (∼22 days) of HQN. We report the impact of concomitant HQN and RDV use on clinical outcomes and safety in patients with moderate COVID-19. Methods: We enrolled hospitalized patients with confirmed SARS-CoV-2 infection, oxygen saturation >94% on room air, and radiological evidence of pneumonia. Patients were randomized 1:1:1 to receive 5d or 10d of intravenous RDV once daily plus standard of care (SoC), or SoC only. We compared patients on concomitant HQN (HQNpos) vs not (HQNneg). Clinical recovery was evaluated using Cox proportional hazards. Covariate adjustment included age, sex, race, region, symptom duration, oxygen support status and obesity. Recovery and adverse events (AEs) were assessed through death, discharge, or d14. Results: Of 584 patients, 199 (34%) received HQN (5d RDV: n=57 [30%];10d RDV, n=49 [25%];SoC: n=93 [47%]). Through median follow-up of 13d (range 1-41d), HQNpos patients on 5d or 10d RDV had a lower recovery rate (adjusted HR [95% CI] 0.78 [0.59, 1.03], p=0.09) with longer median time to recovery (8 vs 6 days) compared to HQNneg. HQNpos compared to HQNneg patients in 5d RDV showed a trend of reduced recovery rate (HR: 0.69 [0.45,1.04], p=0.080);such an effect was not observed in 10d RDV or SoC (Table 1). More HQNpos than HQNneg patients had AEs in RDV (5/10d) or SoC arms evaluated separately, and all arms combined. This difference was significant for AEs and SAEs for all arms combined after covariate adjustment (Table 2). Conclusion: In moderate COVID-19 patients, concomitant HQN may delay recovery on RDV and showed no impact on recovery with SoC alone. The AE profile of HQNpos patients was worse than that observed for HQNneg patients, regardless of RDV treatment.

12.
Rev Esp Quimioter ; 34(3): 238-244, 2021 Jun.
Article in English | MEDLINE | ID: covidwho-1173137

ABSTRACT

OBJECTIVE: In some patients the immune response triggered by SARS-CoV-2 is unbalanced, presenting an acute respiratory distress syndrome which in many cases requires intensive care unit (ICU) admission. The limitation of ICU beds has been one of the major burdens in the management around the world; therefore, clinical strategies to avoid ICU admission are needed. We aimed to describe the influence of tocilizumab on the need of transfer to ICU or death in non-critically ill patients. METHODS: A retrospective study of 171 patients with SARS-CoV-2 infection that did not qualify as requiring transfer to ICU during the first 24h after admission to a conventional ward, were included. The criteria to receive tocilizumab was radiological impairment, oxygen demand or an increasing of inflammatory parameters, however, the ultimate decision was left to the attending physician judgement. The primary outcome was the need of ICU admission or death whichever came first. RESULTS: A total of 77 patients received tocilizumab and 94 did not. The tocilizumab group had less ICU admissions (10.3% vs. 27.6%, P=0.005) and need of invasive ventilation (0 vs 13.8%, P=0.001). In the multivariable analysis, tocilizumab remained as a protective variable (OR: 0.03, CI 95%: 0.007-0.1, P=0.0001) of ICU admission or death. CONCLUSIONS: Tocilizumab in early stages of the inflammatory flare could reduce an important number of ICU admissions and mechanical ventilation. The mortality rate of 10.3% among patients receiving tocilizumab appears to be lower than other reports. This is a non-randomized study and the results should be interpreted with caution.


Subject(s)
Antibodies, Monoclonal, Humanized/therapeutic use , COVID-19/mortality , Hospitalization/statistics & numerical data , Intensive Care Units/statistics & numerical data , Bed Occupancy , COVID-19/immunology , Female , Humans , Male , Middle Aged , Respiration, Artificial/statistics & numerical data , Retrospective Studies , SARS-CoV-2
13.
Rev Esp Quimioter ; 34(2): 136-140, 2021 Apr.
Article in English | MEDLINE | ID: covidwho-1119722

ABSTRACT

OBJECTIVE: Controversial results on remdesivir efficacy have been reported. We aimed to report our real-life experience with the use of remdesivir from its availability in Spain. METHODS: We performed a descriptive study of all patients admitted for ≥48 hours with confirmed COVID-19 who received remdesivir between the 1st of July and the 30th of September 2020. RESULTS: A total of 123 patients out of 242 admitted with COVID-19 at our hospital (50.8%) received remdesivir. Median age was 58 years, 61% were males and 56.9 % received at least one anti-inflammatory treatment. No adverse events requiring remdesivir discontinuation were reported. The need of intensive care unit admission, mechanical ventilation and 30-days mortality were 19.5%, 7.3% and 4.1%, respectively. CONCLUSIONS: In our real-life experience, the use of remdesivir in hospitalized patients with COVID-19 was associated with a low mortality rate and good safety profile.


Subject(s)
Adenosine Monophosphate/analogs & derivatives , Alanine/analogs & derivatives , Antiviral Agents/therapeutic use , COVID-19/drug therapy , Inpatients , Adenosine Monophosphate/therapeutic use , Aged , Alanine/therapeutic use , Anti-Inflammatory Agents/therapeutic use , Antibodies, Monoclonal, Humanized/therapeutic use , COVID-19/mortality , Cohort Studies , Dexamethasone/therapeutic use , Female , Hospital Mortality , Humans , Intensive Care Units/statistics & numerical data , Male , Middle Aged , Respiration, Artificial/statistics & numerical data , Spain/epidemiology , Treatment Outcome
15.
J Investig Allergol Clin Immunol ; 30(5): 346-357, 2020.
Article in English | MEDLINE | ID: covidwho-1000713

ABSTRACT

BACKGROUND AND OBJECTIVE: Since the initial anecdotal reports of coronavirus disease 2019 (COVID-19) from China, a growing number of studies have reported on smell and/or taste dysfunction (STD). Objective: The aim of our study was to investigate the frequency and severity of STD in COVID-19 patients and to evaluate the association with demographic characteristics, hospital admission, symptoms, comorbidities, and blood biomarkers. METHODS: We performed a multicenter cross-sectional study on patients who were positive for SARS-CoV-2 (n=846) and controls (n=143) from 15 Spanish hospitals. Data on STD were collected prospectively using an in-person survey. The severity of STD was categorized using a visual analog scale. We analyzed time to onset, recovery rate, time to recovery, hospital admission, pneumonia, comorbidities, smoking, and symptoms. RESULTS: STD was at least 2-fold more common in COVID-19-positive patients than in controls. COVID-19-positive hospitalized patients were older, with a lower frequency of STD, and recovered earlier than outpatients. Analysis stratified by severity of STD showed that more than half of COVID-19 patients presented severe loss of smell (53.7%) or taste (52.2%); both senses were impaired in >90%. In the multivariate analysis, older age (>60 years), being hospitalized, and increased C-reactive protein were associated with a better sense of smell and/or taste. COVID-19-positive patients reported improvement in smell (45.6%) and taste (46.1%) at the time of the survey; in 90.6% this was within 2 weeks of infection. CONCLUSION: STD is a common symptom in COVID-19 and presents mainly in young and nonhospitalized patients. More studies are needed to evaluate follow-up of chemosensory impairment.


Subject(s)
Betacoronavirus , Coronavirus Infections/complications , Coronavirus Infections/epidemiology , Olfaction Disorders/epidemiology , Olfaction Disorders/etiology , Pneumonia, Viral/complications , Pneumonia, Viral/epidemiology , Taste Disorders/epidemiology , Taste Disorders/etiology , Adult , Age Factors , Aged , Aged, 80 and over , Betacoronavirus/genetics , Betacoronavirus/immunology , COVID-19 , Case-Control Studies , Coronavirus Infections/diagnosis , Coronavirus Infections/virology , Cross-Sectional Studies , Female , Hospitalization , Humans , Male , Middle Aged , Olfaction Disorders/diagnosis , Pandemics , Pneumonia, Viral/diagnosis , Pneumonia, Viral/virology , Polymerase Chain Reaction , Public Health Surveillance , SARS-CoV-2 , Severity of Illness Index , Spain/epidemiology , Symptom Assessment , Taste Disorders/diagnosis , Young Adult
16.
Annals of the American Thoracic Society ; 17(9):1164-1168, 2020.
Article in English | GIM | ID: covidwho-972910

ABSTRACT

The aim of the article was to present the characteristics of gas exchange, pulmonary mechanics, and ventilatory management of 50 patients with laboratory-confirmed SARS-CoV-2 infection, who developed ARDS and underwent invasive MV (IMV). By March 25th, 2020, 50 patients with laboratory-confirmed SARS-CoV-2 infection and ARDS had been admitted to our hospital. Table 1 shows the demographic and clinical characteristics of these patients. The median (interquartile range [IQR]) age was 66 (57-74) years. Thirty-six patients (72%) were men. Upon ARDS diagnosis, 44% of patients were initially classified as having moderate ARDS, whereas 24% were classified as having mild ARDS and 32% were classified as having severe ARDS. ICU and hospital lengths of stay were prolonged, and tracheostomy was performed in 30 (60%) patients. Hospital mortality was 34%. SARS-CoV-2-induced ARDS produced an impairment in gas exchange and pulmonary mechanics comparable with those of prior cohorts with non-SARS-CoV-2 ARDS. As in other studies, VR was high, and the most frequent presentation was moderate ARDS. On average, Crs in the cohort with SARS-CoV-2-induced ARDS was also found to be comparable, but with remarkable heterogeneity. Other studies have reported similar, higher, or lower Crs in SARS-CoV-2-induced ARDS. As Crs decreases alongside the collapse of alveolar units due to lung edema, several factors may provide explanations for such reported differences, including treatments, intubation strategies, and the stage of the disease. In our cohort with early SARS-CoV-2-induced ARDS, the time from ICU admission to intubation was only 24 hours, despite the use of high-flow nasal cannula or NIV in some cases. Although driving pressure and end-inspiratory plateau pressure were within the protective range, mechanical power was found to be slightly high and might have promoted lung injury. In patients undergoing prone positioning, PaO2/FiO2 improvement was followed by an increase in Crs, suggesting recruitment and aeration of previously collapsed alveoli. In this study, mortality was similar to that reported in other studies of critically ill patients with SARS-CoV-2 pneumonia.

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