Generalized myoclonus in COVID-19.

OBJECTIVE: To report 3 patients infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) who developed generalized myoclonus. METHODS: Patient data were obtained from medical records from the University Hospital "12 de Octubre," Madrid, Spain. RESULTS: Three patients (2 men and 1 woman, aged 63-88 years) presented with mild hypersomnia and generalized myoclonus following the onset of the so-called inflammatory phase of coronavirus disease 2019 (COVID-19). All of them had presented previously with anosmia. Myoclonus was generalized with both positive and negative jerks, predominantly involving the facial, trapezius, sternocleidomastoid, and upper extremities muscles. These myoclonic jerks occurred spontaneously and were extremely sensitive to multisensory stimuli (auditive and tactile) or voluntary movements, with an exaggerated startle response. Other causes of myoclonus were ruled out, and none of the patients had undergone respiratory arrest or significant prolonged hypoxia. All of them improved, at least partially, with immunotherapy. CONCLUSIONS: Our 3 cases highlight the occurrence of myoclonus during the COVID-19 pandemic as a post- or para-infectious immune-mediated disorder. However, we cannot rule out that SARS-CoV-2 may spread transneuronally to first- and second-order structures connected with the olfactory bulb. Further investigation is required to clarify the full clinical spectrum of neurologic symptoms and optimal treatment.

Cuando el médico se convierte en paciente: la salud de los médicos de los Hospitales Universitarios de Alicante / When de doctor becomes a patient: physician health in University Hospitals in Alicante, Spain

Objetivo: Describir indicadores de salud y sus determinantes en una muestra de médicos hospitalarios. Métodos: Estudio descriptivo transversal mediante encuesta realizado entre julio de 2010 y julio de 2011. El estudio se realizó entre los facultativos de los Hospitales de Alicante, Elche y Sant Joan d’Alacant. Se realizó un muestreo de conveniencia. Se obtuvieron 281 cuestionarios válidos (18,8% del total de la población de interés). Las principales variables de estudio fueron referentes a la salud autopercibida, hábitos de vida, condiciones de trabajo y comportamiento frente a la enfermedad. Se calculan estimadores de frecuencia y distribución. Resultados: La salud autopercibida por los médicos es buena. Un 40% sufre alguna enfermedad crónica y un 64% se automedica. Solo un 43% ha acudido a su médico de familia desde que es médico y un 50% realiza consultas sanitarias informalmente. Menos de un 35% acude a revisiones preventivas. La mayoría califica su trabajo como poco monótono, estresante y satisfactorio, afirmando que afecta a su salud y genera estrés y alteraciones del sueño. Conclusiones: En el colectivo estudiado el comportamiento frente a la enfermedad se caracteriza por la autonomía, la informalidad en el itinerario asistencial y las dificultades para adoptar el rol de enfermo, con actitudes preventivas insuficientes. Consideran que el ejercicio médico afecta a su salud causando estrés y alteraciones del sueño (AU)

Objective: To describe health indicators and health determinants in a sample of hospital physicians. Methods: Cross-sectional descriptive survey carried out between July 2010 and July 2011. The population of interest were physicians employed at the hospitals of Alicante, Elche and Sant Joan d’Alacant. This was a convenience sample from which we obtained 281 valid questionnaires (18.8% of the population). Study variables included perceived health status, lifestyle, working conditions and illness behavior. Frequencies and distributions of these variables were. Results: Overall, self-perceived health in our sample of doctors was good. Forty percent reported having a chronic illness and 64% self-medicated. Only 43% had seen their primary care physician since becoming physicians and 50% relied on informal “curbside” medical consultations. Less than 35% had undergone preventive exams. Most stated their work is never monotonous and described it as stressful and satisfactory. They also felt their work affected their health and generated stress and sleep disturbances. Conclusions: In this study, physician behavior with respect to illness was characterized by autonomy, informality and difficulty in assuming a sick role. Their preventive habits are insufficient. They consider that medical practice affects their health, generating stress and sleep disturbances (AU)

[When the doctor becomes a patient: physician health in university hospitals in Alicante, Spain]. / Cuando el médico se convierte en paciente: la salud de los médicos de los Hospitales Universitarios de Alicante.

OBJECTIVE: To describe health indicators and health determinants in a sample of hospital physicians. METHODS: Cross-sectional descriptive survey carried out between July 2010 and July 2011. The population of interest were physicians employed at the hospitals of Alicante, Elche and Sant Joan d'Alacant. This was a convenience sample from which we obtained 281 valid questionnaires (18.8% of the population). Study variables included perceived health status, lifestyle, working conditions and illness behavior. Frequencies and distributions of these variables were calculated. RESULTS: Overall, self-perceived health in our sample of doctors was good. Forty percent reported having a chronic illness and 64% self-medicated. Only 43% had seen their primary care physician since becoming physicians and 50% relied on informal "curbside" medical consultations. Less than 35% had undergone preventive exams. Most stated their work is never monotonous and described it as stressful and satisfactory. They also felt their work affected their health and generated stress and sleep disturbances. CONCLUSIONS: In this study, physician behavior with respect to illness was characterized by autonomy, informality and difficulty in assuming a sick role. Their preventive habits are insufficient. They consider that medical practice affects their health, generating stress and sleep disturbances.

OBJETIVO: Describir indicadores de salud y sus determinantes en una muestra de médicos hospitalarios. MÉTODOS: Estudio descriptivo transversal mediante encuesta realizado entre julio de 2010 y julio de 2011. El estudio se realizó entre los facultativos de los Hospitales de Alicante, Elche y Sant Joan d'Alacant. Se realizó un muestreo de conveniencia. Se obtuvieron 281 cuestionarios válidos (18,8% del total de la población de interés). Las principales variables de estudio fueron referentes a la salud autopercibida, hábitos de vida, condiciones de trabajo y comportamiento frente a la enfermedad. Se calculan estimadores de frecuencia y distribución. RESULTADOS: La salud autopercibida por los médicos es buena. Un 40% sufre alguna enfermedad crónica y un 64% se automedica. Solo un 43% ha acudido a su médico de familia desde que es médico y un 50% realiza consultas sanitarias informalmente. Menos de un 35% acude a revisiones preventivas. La mayoría califica su trabajo como poco monótono, estresante y satisfactorio, afirmando que afecta a su salud y genera estrés y alteraciones del sueño. CONCLUSIONES: En el colectivo estudiado el comportamiento frente a la enfermedad se caracteriza por la autonomía, la informalidad en el itinerario asistencial y las dificultades para adoptar el rol de enfermo, con actitudes preventivas insuficientes. Consideran que el ejercicio médico afecta a su salud causando estrés y alteraciones del sueño.