Effectiveness of Telephone Monitoring in Primary Care to Detect Pneumonia and Associated Risk Factors in Patients with SARS-CoV-2.

Improved technology facilitates the acceptance of telemedicine. The aim was to analyze the effectiveness of telephone follow-up to detect severe SARS-CoV-2 cases that progressed to pneumonia. A prospective cohort study with 2-week telephone follow-up was carried out March 1 to May 4, 2020, in a primary healthcare center in Barcelona. Individuals aged ≥15 years with symptoms of SARS-CoV-2 were included. Outpatients with non-severe disease were called on days 2, 4, 7, 10 and 14 after diagnosis; patients with risk factors for pneumonia received daily calls through day 5 and then the regularly scheduled calls. Patients hospitalized due to pneumonia received calls on days 1, 3, 7 and 14 post-discharge. Of the 453 included patients, 435 (96%) were first attended to at a primary healthcare center. The 14-day follow-up was completed in 430 patients (99%), with 1798 calls performed. Of the 99 cases of pneumonia detected (incidence rate 20.8%), one-third appeared 7 to 10 days after onset of SARS-CoV-2 symptoms. Ten deaths due to pneumonia were recorded. Telephone follow-up by a primary healthcare center was effective to detect SARS-CoV-2 pneumonias and to monitor related complications. Thus, telephone appointments between a patient and their health care practitioner benefit both health outcomes and convenience.

Impact of the new criteria of the ACC/AHA on the diagnostic prevalence of hypertension. / Impacto de los nuevos criterios de la ACC/AHA sobre la prevalencia diagnóstica de hipertensión arterial.

OBJECTIVE: To study the impact on the prevalence of hypertension with the criteria (2017) of the American College of Cardiology/American Heart Association (ACC/AHA). PATIENTS AND METHODS: Cross-sectional study, including 370 patients ≥18 years, randomly selected in a Health Centre, with at least one visit and a measurement of systolic (SBP) and diastolic blood pressure (DBP) recorded the last 2 years. Previous hypertension was considered if the diagnosis was confirmed or they had an SBP ≥140 or DBP ≥90mmHg and as ACC/AHA AHT criteria in any of these cases or an SBP between 130-139mmHg or DBP between 80-89mmHg. RESULTS: The average age was 52.3 years (58.6% women). Forty-one point nine percent had previous hypertension, increasing to 67.8% with the ACC/AHA criteria (p <.05). Pharmacological treatment was received by 32.2% of the population, increasing to 38.4% with the ACC/AHA criteria (p>.05). The newly diagnosed patients (p <.05) were younger (mean difference 19.6 years) and less obese (23% vs. 41.4%). CONCLUSIONS: The ACC/AHA criteria would represent an increase of 25.9% in the prevalence of hypertension, considering 2 out of 3 adults hypertensive.