Asunto(s)
COVID-19/prevención & control , Presión de las Vías Aéreas Positiva Contínua/estadística & datos numéricos , Cooperación del Paciente/estadística & datos numéricos , Apnea Obstructiva del Sueño/terapia , Adulto , Anciano , Femenino , Francia , Política de Salud , Humanos , Modelos Lineales , Estudios Longitudinales , Masculino , Persona de Mediana EdadAsunto(s)
COVID-19/epidemiología , Presión de las Vías Aéreas Positiva Contínua/estadística & datos numéricos , Pandemias , Cooperación del Paciente/estadística & datos numéricos , SARS-CoV-2 , Apnea Obstructiva del Sueño/terapia , Anciano , COVID-19/psicología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Cuarentena/estadística & datos numéricos , Índice de Severidad de la Enfermedad , Factores Sexuales , España/epidemiología , Estadísticas no Paramétricas , Telemetría/estadística & datos numéricos , Factores de TiempoAsunto(s)
COVID-19/complicaciones , Ventilación de Alta Frecuencia/estadística & datos numéricos , Ventilación no Invasiva/estadística & datos numéricos , Insuficiencia Respiratoria/terapia , Anciano , COVID-19/mortalidad , Presión de las Vías Aéreas Positiva Contínua/estadística & datos numéricos , Ventilación de Alta Frecuencia/mortalidad , Humanos , Persona de Mediana Edad , Ventilación no Invasiva/mortalidad , Terapia por Inhalación de Oxígeno/estadística & datos numéricos , Posición Prona , Sistema de Registros , Insuficiencia Respiratoria/etiología , Insuficiencia Respiratoria/mortalidad , España/epidemiologíaRESUMEN
BACKGROUND: Gender-related factors might affect vulnerability to Covid-19. The aim of this study was to describe the role of gender on clinical features and 28-day mortality in Covid-19 patients. METHODS: Observational study of Covid-19 patients hospitalized in Bergamo, Italy, during the first three weeks of the outbreak. Medical records, clinical, radiological and laboratory findings upon admission and treatment have been collected. Primary outcome was 28-day mortality since hospitalization. RESULTS: 431 consecutive adult patients were admitted. Female patients were 119 (27.6%) with a mean age of 67.0 ± 14.5 years (vs 67.8 ± 12.5 for males, p = 0.54). Previous history of myocardial infarction, vasculopathy and former smoking habits were more common for males. At the time of admission PaO2/FiO2 was similar between men and women (228 [IQR, 134-273] vs 238 mmHg [150-281], p = 0.28). Continuous Positive Airway Pressure (CPAP) assistance was needed in the first 24 h more frequently in male patients (25.7% vs 13.0%; p = 0.006). Overall 28-day mortality was 26.1% in women and 38.1% in men (p = 0.018). Gender did not result an independent predictor of death once the parameters related to disease severity at presentation were included in the multivariable analysis (p = 0.898). Accordingly, the Kaplan-Meier survival analysis in female and male patients requiring CPAP or non-invasive ventilation in the first 24 h did not find a significant difference (p = 0.687). CONCLUSION: Hospitalized women are less likely to die from Covid-19; however, once severe disease occurs, the risk of dying is similar to men. Further studies are needed to better investigate the role of gender in clinical course and outcome of Covid-19.
Asunto(s)
COVID-19/epidemiología , Anciano , Anciano de 80 o más Años , COVID-19/mortalidad , COVID-19/fisiopatología , COVID-19/terapia , Comorbilidad , Presión de las Vías Aéreas Positiva Contínua/estadística & datos numéricos , Diabetes Mellitus/epidemiología , Femenino , Humanos , Hipertensión/epidemiología , Hipoxia/epidemiología , Hipoxia/fisiopatología , Hipoxia/terapia , Italia/epidemiología , Estimación de Kaplan-Meier , Masculino , Persona de Mediana Edad , Infarto del Miocardio/epidemiología , Ventilación no Invasiva/estadística & datos numéricos , SARS-CoV-2 , Índice de Severidad de la Enfermedad , Factores Sexuales , Fumar/epidemiologíaRESUMEN
None: A middle-aged man with obstructive sleep apnea who had been treated with continuous positive airway pressure developed COVID-19. An analysis of airflow records from the continuous positive airway pressure machine revealed a rise in his respiratory rate on the night before the onset of COVID-19-related symptoms, while his nocturnal respiratory rate had been stable during the 18-month period prior to the presently reported episode. The present case suggests that a rise in respiratory rate detected using continuous positive airway pressure machine data could be an important sign of impending acute illness, such as COVID-19. Studies to elucidate the usefulness of this method are warranted.
Asunto(s)
Betacoronavirus , Presión de las Vías Aéreas Positiva Contínua/estadística & datos numéricos , Infecciones por Coronavirus/diagnóstico , Infecciones por Coronavirus/fisiopatología , Neumonía Viral/diagnóstico , Neumonía Viral/fisiopatología , Frecuencia Respiratoria/fisiología , Apnea Obstructiva del Sueño/terapia , COVID-19 , Humanos , Masculino , Persona de Mediana Edad , Pandemias , Polisomnografía/métodos , SARS-CoV-2RESUMEN
The coronavirus disease (COVID-19) pandemic has brought the Italian National Health System to its knees. The abnormally high influx of patients, together with the limited resources available, has forced clinicians to make unprecedented decisions and provide compassionate treatments for which little or no evidence is yet available. This is the case for the use of noninvasive positive pressure ventilation and continuous airway pressure ventilation, combined with prone position in patients with COVID-19 and acute respiratory distress syndrome treated outside of intensive care units. In our article, we comment on the evidence available, so far, and provide a brief summary of data collected at our health institution in Piedmont, Italy.