Risks of adverse outcomes in COVID-19 patients and vaccination status in a secondary hospital in Spain.

Introduction: In December 2020, vaccination against SARS-CoV-2 started in Spain. Until March 2022, 91.1% of the target population was vaccinated. The objective of the study is to describe the characteristics of patients with SARS-CoV-2 infection, the risk of serious outcomes and their vaccination status. Material and methods: Retrospective longitudinal analytical observational study. Demographic characteristics and outcomes of COVID-19 infections and vaccination history from 01/01/2021-08/10/2021 were collected from electronic medical records and the Unified Vaccination Registry. Data analysis was performed with Excel and Stata 16. Results: 4161 COVID-19 cases were detected; of which 185 (4.5%) had received a complete vaccination schedule. The most affected age group was 80-89 years (34.1%). 1697 patients were hospitalized, of whom 78 (4.6%) had been vaccinated against SARS-CoV-2. No patient admitted to the ICU had a history of vaccination. The mean hospitalization time in unvaccinated patients was 11 days (95% CI -41.54-63.54) compared to 8.5 days (95% CI 7.04-9.96) in vaccinated patients. The relative risk of hospitalization in vaccinated patients compared to unvaccinated patients for the age group 40 to 59 years was 0.29 (95% CI 0.11-0.72) and 0.77 (95% CI 0.67-0). 0.90) for people over 60 years of age. Conclusions: The risk of hospitalization and death was lower in vaccinated patients compared to unvaccinated patients in the age groups 40-59 and older than 60 years. This finding supports current clinical evidence.

Introducción: En diciembre 2020 inició la vacunación frente al SARS-CoV-2 en España. Hasta principios de marzo 2022 el 91,1% de la población diana ha sido vacunada. El objetivo del estudio es describir las características de los pacientes con infección por SARS-CoV-2, el riesgo de desenlaces graves y el estado de vacunación. Material y métodos: Estudio observacional analítico longitudinal retrospectivo. Se recogieron características demográficas y desenlace de infecciones COVID-19 de casos confirmados y sus antecedentes de vacunación desde 01/01/2021­10/08/2021 de las historias clínicas electrónicas y del Registro Unificado de Vacunación. El análisis de datos se realizó con Excel y Stata 16. Resultados: Se detectaron 4161 casos COVID-19; 185 (4,5%) recibieron pauta de vacunación completa. El grupo de edad más afectado fue 80­89 años (34,1%). 1697 pacientes hospitalizaron, de los cuales 78 (4,6%) recibieron pauta de vacunación completa. Ningún paciente ingresado en UCI tenía antecedentes de vacunación. El tiempo medio de hospitalización en no vacunados fue de 11 días (IC95% -41,54-63,54) frente a 8,5 días (IC95% 7,04-9,96) en vacunados. El riesgo relativo de hospitalización en vacunados respecto a no vacunados para el grupo de edad de 40 a 59 años fue de 0,29 (IC95% 0,11-0,72) y de 0,77 (IC95% 0,67-0,90) para las personas de más de 60 años. Conclusiones: El riesgo de hospitalización y muerte fue menor en los pacientes vacunados en comparación con los no vacunados en los grupos de edad 40­59 y mayores de 60 años. Este hallazgo está de acuerdo con los datos de la evidencia clínica actual.

Childhood obesity and risk of SARS-CoV-2 infection.

OBJECTIVE: To estimate the association between childhood obesity and the risk of SARS-CoV-2 infection in a cohort followed from 4 to 12 years of age. METHODS: The data were obtained from two independent sources: the Longitudinal Childhood Obesity Study (ELOIN) and the epidemiological surveillance system data from the Community of Madrid (Spain), which served to identify the population within the cohort with confirmed SARS-CoV-2 infection. The SARS-CoV-2 registry was cross-checked with the cohort population at 11-12 years of age. A total of 2018 eligible participants were identified in the cohort, who underwent physical examinations at 4, 6, and 9 years of age during which weight, height, and waist circumference were recorded. General obesity (GO) was determined according to the WHO-2007 criteria whereas abdominal obesity (AO) was defined based on the International Diabetes Federation (IDF) criteria. The relative risks (RRs) of infection were estimated using a Poisson regression model and adjusted by sociodemographic variables, physical activity, and perceived health reported by the parents. RESULTS: The accumulated incidence of SARS-CoV-2 infection was 8.6% (95% CI: 7.3-9.8). The estimated RR of SARS-CoV-2 infection was 2.53 (95% CI: 1.56-4.10) and 2.56 (95% CI: 1.55-4.21) for children 4-9 years old with stable GO and AO, respectively, compared with those who did not present GO. CONCLUSIONS: Childhood obesity is an independent risk factor for SARS-CoV-2 infection. This study provides new evidence that indicates that obesity increases the vulnerability of the paediatric population to infectious diseases.

Mortalidad atribuida a telangiectasia hemorrágica hereditaria y variabilidad geográfica en España (1981-2016) / Mortality attributed to hereditary haemorrhagic telangiectasia and geographical variability in Spain (1981-2016)

OBJETIVO: Conocer la mortalidad directamente atribuida a la telangiectasia hemorrágica hereditaria (THH) en España, su tendencia temporal y la posible variabilidad geográfica. MÉTODO: El total de los fallecidos por THH de base poblacional se obtuvo del Instituto Nacional de Estadística, seleccionando los códigos 448.0 (CIE 9-MC, 1981-1998) y I78.0 (CIE 10, 1999-2016) como causa básica de defunción. Se calcularon las tasas de mortalidad específicas y ajustadas por edad para cada sexo, las razones de mortalidad estandarizadas (RME) por provincia y comarca, y las RME suavizadas. RESULTADOS: Se identificaron 327 fallecimientos por THH (el 49,5% eran mujeres), siendo la mortalidad más alta a los 80-84 años en los hombres (0,220 por 100.000 habitantes) y a los 75-79 años en las mujeres (0,147 por 100.000 habitantes). No se detectaron cambios temporales entre 1981 y 2016. Las provincias de Navarra, Cantabria, Guipúzcoa, Pontevedra y Las Palmas presentaron un riesgo significativamente superior con respecto a lo esperado para el total nacional, así como las comarcas de Monte Sur (Ciudad Real) y Ripollès (Girona). CONCLUSIONES: Este trabajo ha permitido identificar algunas regiones con mayor riesgo de defunción por THH, si bien se desconoce si estas diferencias se asocian a la distribución de los tipos THH1 y THH2, por lo que son necesarios estudios posteriores para profundizar en las causas de la variabilidad geográfica. Estos hallazgos complementan la información proporcionada por otros estudios y registros, además de ser útiles para la planificación sanitaria

OBJECTIVE: To identify the mortality directly attributed to hereditary haemorrhagic telangiectasia (HHT) in Spain, and to analyze its time trends and geographic variability. METHOD: Population-based deaths due to HHT were selected from the Spanish National Statistics Institute: codes 448.0 (ICD-9, 1981-1998) and I78.0 (ICD-10, 1999-2016) as the basic cause of death. Specific and age-adjusted mortality rates were calculated by sex, as well as standardized mortality ratios (SMR) by province and district, and smoothed SMR. RESULTS: We identified 327 deaths attributed to HHT (49.5% women), with the highest mortality at 80-84 years in men (0.220 per 100,000 inhabitants) and at 75-79 years in women (0.147 per 100,000 inhabitants). Age-adjusted mortality rates did not show any significant time trend between 1981 and 2016 in Spain. The provinces of Navarra, Cantabria, Guipúzcoa, Pontevedra and Las Palmas had higher than expected mortality, as well as the regions of Monte Sur (Ciudad Real) and Ripollès (Girona). CONCLUSIONS: This study has identified some regions with higher risk of death due to HHT in Spain. It is unknown whether these differences are associated with the distribution of types HHT1 and HHT2, and further studies will be necessary to know the determinants of this geographical variability. These findings are useful to complement the information provided by other studies and registries, and for health planning

[Mortality attributed to hereditary haemorrhagic telangiectasia and geographical variability in Spain (1981-2016)]. / Mortalidad atribuida a telangiectasia hemorrágica hereditaria y variabilidad geográfica en España (1981-2016).

OBJECTIVE: To identify the mortality directly attributed to hereditary haemorrhagic telangiectasia (HHT) in Spain, and to analyze its time trends and geographic variability. METHOD: Population-based deaths due to HHT were selected from the Spanish National Statistics Institute: codes 448.0 (ICD-9, 1981-1998) and I78.0 (ICD-10, 1999-2016) as the basic cause of death. Specific and age-adjusted mortality rates were calculated by sex, as well as standardized mortality ratios (SMR) by province and district, and smoothed SMR. RESULTS: We identified 327 deaths attributed to HHT (49.5% women), with the highest mortality at 80-84 years in men (0.220 per 100,000 inhabitants) and at 75-79 years in women (0.147 per 100,000 inhabitants). Age-adjusted mortality rates did not show any significant time trend between 1981 and 2016 in Spain. The provinces of Navarra, Cantabria, Guipúzcoa, Pontevedra and Las Palmas had higher than expected mortality, as well as the regions of Monte Sur (Ciudad Real) and Ripollès (Girona). CONCLUSIONS: This study has identified some regions with higher risk of death due to HHT in Spain. It is unknown whether these differences are associated with the distribution of types HHT1 and HHT2, and further studies will be necessary to know the determinants of this geographical variability. These findings are useful to complement the information provided by other studies and registries, and for health planning.