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British Journal of Oral and Maxillofacial Surgery ; 2020.
Artículo | WHO COVID | ID: covidwho-753857


The purpose of this study was to undertake a retrospective cross-sectional analysis that compared the frequency and characteristics of facial injury presentations at a UK and an Australian tertiary referral hospital during COVID-19 social distancing The primary predictor variables were a heterogeneous set of factors grouped into logical categories: demographics, injury mechanisms and site, and management The primary outcome variable was the presentation of a hard or soft tissue facial injury A descriptive statistical analysis was undertaken on the assembled data The study found a clinical and statistically significant reduction in the frequency (absolute numbers) and prevalence (number per 1000 population) of facial injuries at each study site In addition, the striking similarity common in both countries was an increase in facial injury due to falls and a decrease in facial injury due to interpersonal violence Conservative (non-operative) management of facial injury increased at both sites The implementation of COVID-19 social distancing public health measures, aimed at limiting the community transmission of coronavirus, had a secondary serendipitous effect in reducing the frequency of facial injury presentations and altering its epidemiological characteristics at both a UK and Australian tertiary referral hospital

JAMA ; 323(20): 2052-2059, 2020 May 26.
Artículo en Inglés | MEDLINE | ID: covidwho-101977


Importance: There is limited information describing the presenting characteristics and outcomes of US patients requiring hospitalization for coronavirus disease 2019 (COVID-19). Objective: To describe the clinical characteristics and outcomes of patients with COVID-19 hospitalized in a US health care system. Design, Setting, and Participants: Case series of patients with COVID-19 admitted to 12 hospitals in New York City, Long Island, and Westchester County, New York, within the Northwell Health system. The study included all sequentially hospitalized patients between March 1, 2020, and April 4, 2020, inclusive of these dates. Exposures: Confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection by positive result on polymerase chain reaction testing of a nasopharyngeal sample among patients requiring admission. Main Outcomes and Measures: Clinical outcomes during hospitalization, such as invasive mechanical ventilation, kidney replacement therapy, and death. Demographics, baseline comorbidities, presenting vital signs, and test results were also collected. Results: A total of 5700 patients were included (median age, 63 years [interquartile range {IQR}, 52-75; range, 0-107 years]; 39.7% female). The most common comorbidities were hypertension (3026; 56.6%), obesity (1737; 41.7%), and diabetes (1808; 33.8%). At triage, 30.7% of patients were febrile, 17.3% had a respiratory rate greater than 24 breaths/min, and 27.8% received supplemental oxygen. The rate of respiratory virus co-infection was 2.1%. Outcomes were assessed for 2634 patients who were discharged or had died at the study end point. During hospitalization, 373 patients (14.2%) (median age, 68 years [IQR, 56-78]; 33.5% female) were treated in the intensive care unit care, 320 (12.2%) received invasive mechanical ventilation, 81 (3.2%) were treated with kidney replacement therapy, and 553 (21%) died. As of April 4, 2020, for patients requiring mechanical ventilation (n = 1151, 20.2%), 38 (3.3%) were discharged alive, 282 (24.5%) died, and 831 (72.2%) remained in hospital. The median postdischarge follow-up time was 4.4 days (IQR, 2.2-9.3). A total of 45 patients (2.2%) were readmitted during the study period. The median time to readmission was 3 days (IQR, 1.0-4.5) for readmitted patients. Among the 3066 patients who remained hospitalized at the final study follow-up date (median age, 65 years [IQR, 54-75]), the median follow-up at time of censoring was 4.5 days (IQR, 2.4-8.1). Conclusions and Relevance: This case series provides characteristics and early outcomes of sequentially hospitalized patients with confirmed COVID-19 in the New York City area.