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1.
JMIR Public Health Surveill ; 6(3): e21163, 2020 07 17.
Artículo en Inglés | MEDLINE | ID: covidwho-690445

RESUMEN

BACKGROUND: The coronavirus disease (COVID-19) pandemic has caused an unprecedented worldwide public health crisis that requires new management approaches. COVIDApp is a mobile app that was adapted for the management of institutionalized individuals in long-term care facilities. OBJECTIVE: The aim of this paper is to report the implementation of this innovative tool for the management of long-term care facility residents as a high-risk population, specifically for early identification and self-isolation of suspected cases, remote monitoring of mild cases, and real-time monitoring of the progression of the infection. METHODS: COVIDApp was implemented in 196 care centers in collaboration with 64 primary care teams. The following parameters of COVID-19 were reported daily: signs/symptoms; diagnosis by reverse transcriptase-polymerase chain reaction; absence of symptoms for ≥14 days; total deaths; and number of health care workers isolated with suspected COVID-19. The number of at-risk centers was also described. RESULTS: Data were recorded from 10,347 institutionalized individuals and up to 4000 health care workers between April 1 and 30, 2020. A rapid increase in suspected cases was seen until day 6 but decreased during the last two weeks (from 1084 to 282 cases). The number of confirmed cases increased from 419 (day 6) to 1293 (day 22) and remained stable during the last week. Of the 10,347 institutionalized individuals, 5,090 (49,2%) remained asymptomatic for ≥14 days. A total of 854/10,347 deaths (8.3%) were reported; 383 of these deaths (44.8%) were suspected/confirmed cases. The number of isolated health care workers remained high over the 30 days, while the number of suspected cases decreased during the last 2 weeks. The number of high-risk long-term care facilities decreased from 19/196 (9.5%) to 3/196 (1.5%). CONCLUSIONS: COVIDApp can help clinicians rapidly detect and remotely monitor suspected and confirmed cases of COVID-19 among institutionalized individuals, thus limiting the risk of spreading the virus. The platform shows the progression of infection in real time and can aid in designing new monitoring strategies.


Asunto(s)
Infecciones por Coronavirus/prevención & control , Hogares para Ancianos , Aplicaciones Móviles , Casas de Salud , Pandemias/prevención & control , Neumonía Viral/prevención & control , Anciano , Infecciones por Coronavirus/epidemiología , Difusión de Innovaciones , Humanos , Cuidados a Largo Plazo , Neumonía Viral/epidemiología , España/epidemiología
3.
Rev Int Androl ; 18(3): 117-123, 2020.
Artículo en Español | MEDLINE | ID: covidwho-664119

RESUMEN

OBJECTIVE: The main objective of this revision is to summarize the current existing evidence of the potential adverse effects of SARS-CoV-2 on the male reproductive system and provide the recommendations of the Asociación Española de Andrología, Medicina Sexual y Reproductiva (ASESA) concerning the implications of COVID-19 infection in the management of male infertilty patients and testicular endocrine dysfunction. METHODS: A comprehensive systematic literature search of the databases of PubMed, Web of Science, Embase, Medline, Cochrane and MedRxiv, was carried out. RESULTS: The presence of orchitis as a potential complication of the infection by SARS-CoV-2 has not yet been confirmed. One study reported that 19% of males with COVID-19 infection had scrotal symptoms suggestive of viral orchitis which could not be confirmed. It is possible that the virus, rather than infecting the testes directly, may induce a secondary autoimmune response leading to autoimmune orchitis. COVID-19 has been associated with coagulation disorders and thus the orchitis could be the result of segmental vasculitis. Existing data concerning the presence of the virus in semen are contradictory. Only one study reported the presence of RNA in 15.8% of patients with COVID-19. However, the presence of nucleic acid or antigen in semen is not synonyms of viral replication capacity and infectivity. It has been reported an increase in serum levels of LH in males with COVID-19 and a significant reduction in the T/LH and FSH/LH ratios, consistent with subclinical hypogonadism. CONCLUSIONS: The findings of recent reports related to the potential effects of COVID-19 infection on the male reproductive system are based on poorly designed, small sample size studies that provide inconclusive, contradictory results. Since there still exists a theoretical possibility of testicular damage and male infertilty as a result of the infection by COVID-19, males of reproductive age should be evaluated for gonadal function and semen analysis. With regard to the sexual transmission of the virus, there is not sufficient evidence to recommend asymptomatic couples to abstein from having sex in order to protect themselves from being infected by the virus. Additional studies are needed to understand the long-term effects of SARS-CoV-2 on male reproductive function, including male fertility potential and endocrine testicular function.


Asunto(s)
Betacoronavirus , Infecciones por Coronavirus/complicaciones , Pandemias , Neumonía Viral/complicaciones , Salud Reproductiva , Salud Sexual , Adulto , Betacoronavirus/aislamiento & purificación , Betacoronavirus/patogenicidad , Betacoronavirus/fisiología , Hormona Folículo Estimulante/sangre , Humanos , Hipogonadismo/sangre , Hipogonadismo/etiología , Inmunoglobulina G/análisis , Leucocitos , Hormona Luteinizante/sangre , Masculino , Orquitis/etiología , Orquitis/virología , Próstata/virología , ARN Viral/análisis , Reacción en Cadena de la Polimerasa de Transcriptasa Inversa , Semen/virología , Preservación de Semen , España , Testículo/inmunología , Testículo/patología , Testículo/virología , Testosterona/sangre , Vasculitis/etiología , Adulto Joven
4.
Arch Bronconeumol ; 56 Suppl 2: 19-26, 2020 07.
Artículo en Inglés, Español | MEDLINE | ID: covidwho-663262

RESUMEN

This consensus document has been drawn up by the Techniques and Transplantation and Nursing areas of the Spanish Society of Pulmonology and Thoracic Surgery (SEPAR) and the Spanish Society of Respiratory Endoscopy (AEER) with the aim of providing information on the safe and effective use of bronchoscopy in patients with suspected or confirmed COVID-19 infection. Our priority is to ensure the safety of our patients, the health workers caring for them, and the community in general. At this stage in the pandemic, our information on the use of bronchoscopy in patients of this type is based on the experience of hospitals in other countries, and scientific publications are scarce. The objective of this document is to compile these experiences, based on recommendations from official agencies, in a document offering guidance in daily clinical practice.


Asunto(s)
Betacoronavirus , Broncoscopía/métodos , Consenso , Infecciones por Coronavirus/diagnóstico , Neumonía Viral/diagnóstico , Broncoscopios/normas , Broncoscopía/efectos adversos , Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/prevención & control , Desinfección/métodos , Personal de Salud , Humanos , Pandemias/prevención & control , Equipo de Protección Personal/normas , Neumonía Viral/epidemiología , Neumonía Viral/prevención & control , Ropa de Protección/normas , Neumología , Sociedades Médicas , España , Manejo de Especímenes/métodos
5.
Farm Hosp ; 44(4): 135-140, 2020 07 01.
Artículo en Inglés | MEDLINE | ID: covidwho-660916

RESUMEN

OBJECTIVE: To analyze the status of the implementation and development of  telepharmacy as applied to the pharmaceutical care of outpatients treated at  hospital pharmacy services in Spain during the COVID-19 pandemic. METHOD: Six weeks after the beginning of the confinement period, an online 10- question survey was sent to all members of the Spanish Society of Hospital  Pharmacists. A single response per hospital was requested. The survey included  questions on the provision of remote pharmaceutical care prior to the onset of  the health crisis, patient selection criteria, procedures for home delivery of  medications and the means used to deliver them, the number of patients who  benefited from telepharmacy, and the number of referrals made. Finally,  respondents were asked whether a teleconsultation was carried out before  sending patients their medication and whether these deliveries were recorded. RESULTS: A total of 39.3% (n = 185) of all the hospitals in the National Health  System (covering all of Spain's autonomous regions) responded to the survey.  Before the beginning of the crisis, 83.2% (n = 154) of hospital pharmacy  services did not carry out remote pharmaceutical care activities that included  telepharmacy with remote delivery of medication. During the study period,  119,972 patients were treated, with 134,142 deliveries of medication being  completed. Most hospitals did not use patient selection criteria. A total of 30.2%  of hospitals selected patients based on their personal circumstances. Home  delivery and informed delivery (87%; 116,129 deliveries) was the option used in most cases. The means used to deliver the medication mainly included the use  of external courier services (47.0%; 87 hospitals) or the hospital's own transport services (38.4%; 71 hospitals). As many as 87.6% of hospitals carried out  teleconsultations prior to sending out medications and 59.6% recorded their  telepharmacy activities in the hospital pharmacy appointments record. CONCLUSIONS: The rate of implementation of telepharmacy in outpatient care in  Spain during the study period in the pandemic was high. This made it possible to guarantee the continuity of care for a large number of patients.


Asunto(s)
Atención Ambulatoria/estadística & datos numéricos , Betacoronavirus , Infecciones por Coronavirus , Pandemias , Servicio de Farmacia en Hospital/estadística & datos numéricos , Neumonía Viral , Telemedicina/estadística & datos numéricos , Encuestas de Atención de la Salud , Servicios de Atención de Salud a Domicilio/organización & administración , Capacidad de Camas en Hospitales , Humanos , Sistemas de Medicación/organización & administración , Sistemas de Medicación/estadística & datos numéricos , Selección de Paciente , Servicio de Farmacia en Hospital/organización & administración , Derivación y Consulta/estadística & datos numéricos , España , Telemedicina/organización & administración , Carga de Trabajo
9.
Emergencias ; 32(4): 242-252, 2020.
Artículo en Inglés, Español | MEDLINE | ID: covidwho-659965

RESUMEN

OBJECTIVES: The primary objective was to describe the clinical characteristics and 30-day mortality rates in emergency department patients with coronavirus disease 2019 (COVID-19) in different diagnostic groupings. MATERIAL AND METHODS: Secondary analysis of the COVID-19 registry compiled by the emergency department of Hospital Clínico San Carlos in Madrid, Spain. We selected suspected COVID-19 cases treated in the emergency department between February 28 and March 31, 2020. The cases were grouped as follows: 1) suspected, no polymerase chain reaction (PCR) test (S/no-PCR); 2) suspected, negative PCR (S/PCR-); 3) suspected, positive PCR (S/PCR+); 4) highly suspected, no PCR, or negative PCR (HS/no or PCR-); and 5) highly suspected, positive PCR (HS/PCR+). We collected clinical, radiologic, and microbiologic data related to the emergency visit. The main outcome was 30-day all-cause mortality. Secondary outcomes were hospitalization and clinical severity of the episode. RESULTS: A total of 1993 cases (90.9%) were included as follows: S/no-PCR, 17.2%; S/PCR-, 11.4%; S/PCR+, 22.1%; HS/no PCR or PCR-, 11.7%; and HS/PCR+, 37.6%. Short-term outcomes differed significantly in the different groups according to demographic characteristics; comorbidity and clinical, radiographic, analytical, and therapeutic variables. Thirty-day mortality was 11.5% (56.5% in hospitalized cases and 19.6% in cases classified as severe). The 2 HS categories and the S/PCR+ category had a greater adjusted risk for 30-day mortality and for having a clinically severe episode during hospitalization in comparison with S/PCR- cases. Only the 2 HS categories showed greater risk for hospitalization than the S/PCR- cases. CONCLUSION: COVID-19 diagnostic groups differ according to clinical and laboratory characteristics, and the differences are associated with the 30-day prognosis.


Asunto(s)
Betacoronavirus , Infecciones por Coronavirus/diagnóstico , Infecciones por Coronavirus/mortalidad , Neumonía Viral/diagnóstico , Neumonía Viral/mortalidad , Adulto , Causas de Muerte , Comorbilidad , Intervalos de Confianza , Infecciones por Coronavirus/complicaciones , Infecciones por Coronavirus/terapia , Grupos Diagnósticos Relacionados , Servicio de Urgencia en Hospital/estadística & datos numéricos , Femenino , Humanos , Masculino , Persona de Mediana Edad , Pandemias , Neumonía Viral/complicaciones , Neumonía Viral/terapia , Reacción en Cadena de la Polimerasa/estadística & datos numéricos , Sistema de Registros/estadística & datos numéricos , España/epidemiología , Evaluación de Síntomas , Factores de Tiempo , Resultado del Tratamiento
10.
Emergencias ; 32(4): 253-257, 2020.
Artículo en Inglés, Español | MEDLINE | ID: covidwho-659492

RESUMEN

OBJECTIVES: To analyze clinical, laboratory, and radiologic findings and final health outcomes in patients with pulmonary embolism and coronavirus disease 2019 (COVID-19). To compare them to findings and outcomes in patients with pulmonary embolism without COVID-19. MATERIAL AND METHODS: Multicenter, observational, retrospective study in 4 Spanish hospital emergency departments (EDs) from January 15 to April 15, 2020. Cases were located by reviewing all ED requests for pulmonary computed tomography angiography (CTA) procedures. Clinical, laboratory, and radiologic findings; medical histories and comorbidity; risk factors; and outcomes were compared between the 2 groups of patients (with or without COVID-19). RESULTS: A total of 399 CTAs were ordered; 88 pulmonary embolisms were diagnosed, 28 of them (32%) in patients with COVID-19. This group had more men, and a history of thromboembolic disease was more common. We found no between-group differences in clinical presentation, laboratory, or radiologic findings; nor were there differences in final outcomes. In-hospital mortality was 7% (2 cases) in patients with COVID-19 and 17% (10 cases) in patients without the virus (odds ratio for death in patients with pulmonary embolism and COVID-19, 0.38; 95% CI, 0.08-1.89). CONCLUSION: We found no clinically important differences in the clinical, laboratory, or radiologic findings between patients with or without COVID-19 who were treated for pulmonary embolism in our hospital EDs. Final outcomes also did not differ.


Asunto(s)
Betacoronavirus , Infecciones por Coronavirus/complicaciones , Neumonía Viral/complicaciones , Embolia Pulmonar/diagnóstico por imagen , Anciano , Comorbilidad , Angiografía por Tomografía Computarizada/estadística & datos numéricos , Infecciones por Coronavirus/sangre , Infecciones por Coronavirus/diagnóstico , Infecciones por Coronavirus/mortalidad , Servicio de Urgencia en Hospital/estadística & datos numéricos , Femenino , Mortalidad Hospitalaria , Humanos , Unidades de Cuidados Intensivos , Intubación Intratraqueal , Tiempo de Internación , Masculino , Oportunidad Relativa , Pandemias , Neumonía Viral/sangre , Neumonía Viral/diagnóstico , Neumonía Viral/mortalidad , Embolia Pulmonar/sangre , Embolia Pulmonar/etiología , Embolia Pulmonar/mortalidad , Estudios Retrospectivos , Factores de Riesgo , España/epidemiología
11.
Emergencias ; 32(4): 233-241, 2020.
Artículo en Inglés, Español | MEDLINE | ID: covidwho-659182

RESUMEN

OBJECTIVES: To describe the clinical characteristics of patients with coronavirus disease 2019 (COVID-19) treated in hospital emergency departments (EDs) in Spain, and to assess associations between characteristics and outcomes. MATERIAL AND METHODS: Prospective, multicenter, nested-cohort study. Sixty-one EDs included a random sample of all patients diagnosed with COVID-19 between March 1 and April 30, 2020. Demographic and baseline health information, including concomitant conditions; clinical characteristics related to the ED visit and complementary test results; and treatments were recorded throughout the episode in the ED. We calculated crude and adjusted odds ratios for risk of in-hospital death and a composite outcome consisting of the following events: intensive care unit admission, orotracheal intubation or mechanical ventilation, or in-hospital death. The logistic regression models were constructed with 3 groups of independent variables: the demographic and baseline health characteristics, clinical characteristics and complementary test results related to the ED episode, and treatments. RESULTS: The mean (SD) age of patients was 62 (18) years. Most had high- or low-grade fever, dry cough, dyspnea, and diarrhea. The most common concomitant conditions were cardiovascular diseases, followed by respiratory diseases and cancer. Baseline patient characteristics that showed a direct and independent association with worse outcome (death and the composite outcome) were age and obesity. Clinical variables directly associated with worse outcomes were impaired consciousness and pulmonary crackles; headache was inversely associated with worse outcomes. Complementary test findings that were directly associated with outcomes were bilateral lung infiltrates, lymphopenia, a high platelet count, a D-dimer concentration over 500 mg/dL, and a lactate-dehydrogenase concentration over 250 IU/L in blood. CONCLUSION: This profile of the clinical characteristics and comorbidity of patients with COVID-19 treated in EDs helps us predict outcomes and identify cases at risk of exacerbation. The information can facilitate preventive measures and improve outcomes.


Asunto(s)
Betacoronavirus , Infecciones por Coronavirus/diagnóstico , Infecciones por Coronavirus/epidemiología , Servicio de Urgencia en Hospital/estadística & datos numéricos , Neumonía Viral/diagnóstico , Neumonía Viral/epidemiología , Evaluación de Síntomas , Adolescente , Adulto , Distribución por Edad , Factores de Edad , Anciano , Anciano de 80 o más Años , Enfermedades Cardiovasculares/epidemiología , Niño , Preescolar , Comorbilidad , Infecciones por Coronavirus/mortalidad , Infecciones por Coronavirus/terapia , Femenino , Mortalidad Hospitalaria , Humanos , Lactante , Recién Nacido , Intubación Intratraqueal/estadística & datos numéricos , Modelos Logísticos , Masculino , Persona de Mediana Edad , Neoplasias/epidemiología , Obesidad/complicaciones , Oportunidad Relativa , Pandemias , Neumonía Viral/mortalidad , Neumonía Viral/terapia , Pronóstico , Estudios Prospectivos , Trastornos Respiratorios/epidemiología , Respiración Artificial/estadística & datos numéricos , Distribución por Sexo , España/epidemiología , Adulto Joven
13.
Emergencias ; 32(4): 227-232, 2020.
Artículo en Inglés, Español | MEDLINE | ID: covidwho-658674

RESUMEN

OBJECTIVES: To evaluate the effectiveness of a coronavirus disease 2019 (COVID-19) prevention and control program for health care workers in a tertiary care hospital emergency department (ED). MATERIAL AND METHODS: We recorded the number of confirmed COVID-19 workers in the ED on March 2, 2020, and April 12, 2020. Workers were screened if they had symptoms or were traced as contacts. Variables recorded were age, sex, staff position, work area, and reason for contact. We used the χ2 test to compare ED workers to workers in other areas of the health care system. RESULTS: Of the 3900 health care workers (279 in the ED), 1744 cases (92 in the ED) were included for analysis. A total of 736 workers (52 in the ED) had symptoms, and 151 had positive test results (9 from the ED). Two of the infections in the ED workers (22.2%) were attributed to patient contact and 7 (77.8%) to nonwork-related contact either in the workplace or in the community. The prevalence of COVID-19 among ED workers was 3.2% (9/279). The prevalence among other health system workers was 3.9% (142/3621). The differences in COVID-19 prevalence between the 2 groups was not significant. Nor was there a significant difference in the reasons for contact with the virus between the 2 groups. CONCLUSION: Based on the prevalence of COVID-19 among ED workers and other health care workers, the reasons for risk of contact with the virus, and the time frame for gathering the data, we conclude that the prevention and control measures in the ED have been effective.


Asunto(s)
Betacoronavirus , Infecciones por Coronavirus/epidemiología , Servicio de Urgencia en Hospital/estadística & datos numéricos , Personal de Salud/estadística & datos numéricos , Enfermedades Profesionales/epidemiología , Neumonía Viral/epidemiología , Centros de Atención Terciaria/estadística & datos numéricos , Adulto , Anciano , Infecciones por Coronavirus/prevención & control , Infecciones por Coronavirus/transmisión , Femenino , Hospitales Universitarios/estadística & datos numéricos , Humanos , Masculino , Persona de Mediana Edad , Enfermedades Profesionales/prevención & control , Pandemias/prevención & control , Neumonía Viral/prevención & control , Neumonía Viral/transmisión , Prevalencia , Evaluación de Programas y Proyectos de Salud , España/epidemiología
16.
Am Surg ; 86(6): 577-584, 2020 Jun.
Artículo en Inglés | MEDLINE | ID: covidwho-656711

RESUMEN

Under the aegis of the American College of Surgeons (ACS), the senior author (SDW), a member of the Board of Regents of the ACS, interviewed 3 of his international colleagues in colon and rectal surgery who found themselves dealing with a flood of patients from the COVID-19 pandemic. Each was in a "hot spot" where the outbreak overwhelmed the capacities of the hospitals. Professor Antonino Spinelli of Milan dealt with the sudden increase in COVID-19 patients that threatened to push all other emergencies and urgent cancer cases aside. Providers lacked the personal protective equipment to be adequately safe in the environment. In Madrid, Dr Julio Mayol recounted how 10%-15% of the workers in his hospital were incapacitated by the virus, many of them doctors providing direct care to patients. The disease is so prevalent that all emergency patients are treated as though they have the infection. Having practices in Saudi Arabia and Spain, Dr Delia Cortés-Guiral saw how the former country controlled the epidemic through a strict lockdown of travel and closure of holy pilgrimage sites and social gatherings. In contrast, upon her return to her native country, she experienced the near-breakdown of the health care system by the suddenness of the outbreak. "There are now no specialists now, she says." All of the specialties are treating COVID-19 patients and all of us are learning at the same time how to deal with this disease."It is a nightmare now here in Spain".


Asunto(s)
Infecciones por Coronavirus/terapia , Pandemias , Rol del Médico , Neumonía Viral/terapia , Cirujanos , Betacoronavirus , Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/transmisión , Servicio de Urgencia en Hospital , Humanos , Transmisión de Enfermedad Infecciosa de Profesional a Paciente/prevención & control , Italia/epidemiología , Cuerpo Médico de Hospitales , Neumonía Viral/epidemiología , Neumonía Viral/transmisión , Arabia Saudita/epidemiología , Aislamiento Social , España/epidemiología , Procedimientos Quirúrgicos Operativos
18.
Rev Int Androl ; 18(3): 117-123, 2020.
Artículo en Español | MEDLINE | ID: covidwho-654221

RESUMEN

OBJECTIVE: The main objective of this revision is to summarize the current existing evidence of the potential adverse effects of SARS-CoV-2 on the male reproductive system and provide the recommendations of the Asociación Española de Andrología, Medicina Sexual y Reproductiva (ASESA) concerning the implications of COVID-19 infection in the management of male infertilty patients and testicular endocrine dysfunction. METHODS: A comprehensive systematic literature search of the databases of PubMed, Web of Science, Embase, Medline, Cochrane and MedRxiv, was carried out. RESULTS: The presence of orchitis as a potential complication of the infection by SARS-CoV-2 has not yet been confirmed. One study reported that 19% of males with COVID-19 infection had scrotal symptoms suggestive of viral orchitis which could not be confirmed. It is possible that the virus, rather than infecting the testes directly, may induce a secondary autoimmune response leading to autoimmune orchitis. COVID-19 has been associated with coagulation disorders and thus the orchitis could be the result of segmental vasculitis. Existing data concerning the presence of the virus in semen are contradictory. Only one study reported the presence of RNA in 15.8% of patients with COVID-19. However, the presence of nucleic acid or antigen in semen is not synonyms of viral replication capacity and infectivity. It has been reported an increase in serum levels of LH in males with COVID-19 and a significant reduction in the T/LH and FSH/LH ratios, consistent with subclinical hypogonadism. CONCLUSIONS: The findings of recent reports related to the potential effects of COVID-19 infection on the male reproductive system are based on poorly designed, small sample size studies that provide inconclusive, contradictory results. Since there still exists a theoretical possibility of testicular damage and male infertilty as a result of the infection by COVID-19, males of reproductive age should be evaluated for gonadal function and semen analysis. With regard to the sexual transmission of the virus, there is not sufficient evidence to recommend asymptomatic couples to abstein from having sex in order to protect themselves from being infected by the virus. Additional studies are needed to understand the long-term effects of SARS-CoV-2 on male reproductive function, including male fertility potential and endocrine testicular function.


Asunto(s)
Betacoronavirus , Infecciones por Coronavirus/complicaciones , Pandemias , Neumonía Viral/complicaciones , Salud Reproductiva , Salud Sexual , Adulto , Betacoronavirus/aislamiento & purificación , Betacoronavirus/patogenicidad , Betacoronavirus/fisiología , Hormona Folículo Estimulante/sangre , Humanos , Hipogonadismo/sangre , Hipogonadismo/etiología , Inmunoglobulina G/análisis , Leucocitos , Hormona Luteinizante/sangre , Masculino , Orquitis/etiología , Orquitis/virología , Próstata/virología , ARN Viral/análisis , Reacción en Cadena de la Polimerasa de Transcriptasa Inversa , Semen/virología , Preservación de Semen , España , Testículo/inmunología , Testículo/patología , Testículo/virología , Testosterona/sangre , Vasculitis/etiología , Adulto Joven
19.
J Am Med Dir Assoc ; 21(7): 915-918, 2020 Jul.
Artículo en Inglés | MEDLINE | ID: covidwho-651906

RESUMEN

OBJECTIVES: Initial data on COVID-19 infection has pointed out a special vulnerability of older adults. DESIGN: We performed a meta-analysis with available national reports on May 7, 2020 from China, Italy, Spain, United Kingdom, and New York State. Analyses were performed by a random effects model, and sensitivity analyses were performed for the identification of potential sources of heterogeneity. SETTING AND PARTICIPANTS: COVID-19-positive patients reported in literature and national reports. MEASURES: All-cause mortality by age. RESULTS: A total of 611,1583 subjects were analyzed and 141,745 (23.2%) were aged ≥80 years. The percentage of octogenarians was different in the 5 registries, the lowest being in China (3.2%) and the highest in the United Kingdom and New York State. The overall mortality rate was 12.10% and it varied widely between countries, the lowest being in China (3.1%) and the highest in the United Kingdom (20.8%) and New York State (20.99%). Mortality was <1.1% in patients aged <50 years and it increased exponentially after that age in the 5 national registries. As expected, the highest mortality rate was observed in patients aged ≥80 years. All age groups had significantly higher mortality compared with the immediately younger age group. The largest increase in mortality risk was observed in patients aged 60 to 69 years compared with those aged 50 to 59 years (odds ratio 3.13, 95% confidence interval 2.61-3.76). CONCLUSIONS AND IMPLICATIONS: This meta-analysis with more than half million of COVID-19 patients from different countries highlights the determinant effect of age on mortality with the relevant thresholds on age >50 years and, especially, >60 years. Older adult patients should be prioritized in the implementation of preventive measures.


Asunto(s)
Infecciones por Coronavirus/mortalidad , Mortalidad/tendencias , Pandemias/estadística & datos numéricos , Neumonía Viral/mortalidad , Distribución por Edad , Anciano , Anciano de 80 o más Años , China/epidemiología , Infecciones por Coronavirus/epidemiología , Femenino , Humanos , Italia/epidemiología , Masculino , Persona de Mediana Edad , New York/epidemiología , Neumonía Viral/epidemiología , España/epidemiología , Reino Unido/epidemiología
20.
Int J Environ Res Public Health ; 17(14)2020 07 13.
Artículo en Inglés | MEDLINE | ID: covidwho-646768

RESUMEN

The present research was carried out in Spain during the COVID-19 pandemic following emergency school closures in an attempt to avoid the spread of infection. As a result, university students undertaking the final year of education degrees (teaching placements) have been obliged to deliver their teaching from home, adapting their teaching contexts to learning in virtual settings. A novel instrument was designed and validated in order to analyze the impact of learning environments and psychological factors in university students during a period of teaching placements. This took place in an adaptive context (state of confinement). Associations were determined between learning environments and psychological factors in adaptive contexts, in relation to the group to which they belonged (whether undertaking a degree in primary education, physical education and sport, early education or social education), and sex. The present study used a Delphi method, alongside a descriptive and quantitative analysis. The data demonstrate that learning environments differ according to the degree studied. The four analyzed groups revealed significant differences in relation to learning environments and psychological factors in adaptive confinement contexts. The subjects of Primary and Social Education were seen to be related with a greater possibility of being overwhelmed and reporting difficulties. Those more used to physical exercise showed more positive psychological indices. Females reported more negative responses. The conclusion reached is that the results of the present research will enable future additional multi-dimensional analysis to be conducted.


Asunto(s)
Infecciones por Coronavirus/epidemiología , Educación a Distancia , Neumonía Viral/epidemiología , Estudiantes/psicología , Universidades , Adaptación Psicológica , Adulto , Betacoronavirus , Técnica Delfos , Investigación Empírica , Femenino , Humanos , Aprendizaje , Masculino , Pandemias , España , Encuestas y Cuestionarios , Adulto Joven
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