Construyendo la semiología de la COVID-19: los sabios ciegos y el elefante / Building COVID-19's semiology: The blind wise men and the elephant

Objetivo: Construir entre pacientes y profesionales la semiología de la COVID-19 leve y moderada atendida en atención primaria. Método: Investigación cualitativa con enfoque teórico fenomenológico, desde un marco teórico de justicia epistémica, realizada en Cataluña, en el ámbito de la atención primaria, durante la primera ola de la pandemia (abril-mayo de 2020). Participaron 15 pacientes y 9 profesionales. La recogida de datos se realizó mediante entrevistas telefónicas semiestructuradas a pacientes con COVID-19 confirmada con prueba de reacción en cadena de la polimerasa y seguidas en atención primaria, y por las descripciones narrativas semiestructuradas de profesionales. Los datos fueron triangulados por las autoras. Resultados: Se describen los síntomas más frecuentes (fiebre, tos, disnea, cansancio, inapetencia, dolor muscular y articular, y síntomas de vías respiratorias altas) siguiendo la descripción de las personas afectadas y los síntomas que más preocupan. Se analizan las dudas sobre los síntomas y la temporalidad de la semiología. Conclusiones: Los protocolos oficiales deberían incluir el cansancio, la inapetencia, el dolor muscular y articular, y los síntomas de vías respiratorias altas, como manifestaciones frecuentes de la COVID-19, atendiendo al relato de las pacientes. Estos síntomas pueden pasar desapercibidos en las pacientes y para las profesionales puede suponer un retraso en la detección de la enfermedad y el estudio de contactos. Es necesario obtener una descripción detallada de los síntomas y evitar traducirlos a términos médicos preestablecidos, pues con su significado sustituyen e invisibilizan la narración de los pacientes, vuelven a los profesionales sordos y ciegos ante una nueva enfermedad, y dificultan la creación de un relato. (AU)

Objective: Construction of mild and moderate COVID-19's semiology between patients and professionals in primary care. Method: Qualitative investigation in a phenomenological theoretical frame, from an epistemic justice position, settled in Catalonia, primary care settings, during the first wave of COVID-19 pandemic (April–May 2020). 15 patients and 9 professionals participated. Data collection was done through semi-structured phone interviews to patients with a microbiological confirmed diagnostic of COVID-19 and followed at primary care and semi-structured narratives of professionals. Data were triangled by the three authors. Results: We described the most common symptoms (fever, cough, shortness of breath, fatigue, loss of appetite, muscular and joint pain, and high airways symptoms), those that worry them the most, hesitancy about symptoms and semiology's temporality according to the descriptions done by patients. Conclusions: Official protocols should include other symptoms as fatigue, loss of appetite, muscle and joint aches and high airways symptoms as frequent symptoms of COVID-19 attending to the stories of patients. Those unspecified symptoms can be unnoticed by patients and professionals and can delay the detection of disease and the contact tracing in primary care. It is necessary to obtain a detailed description of the symptoms and avoid translating them into pre-established medical terms that with their meaning substitute and make the patients’ report invisible, turning professionals deaf and blind to a new disease and making more difficult for them to build the narration of disease. (AU)

[Building COVID-19's semiology: The blind wise men and the elephant]. / Construyendo la semiología de la COVID-19: los sabios ciegos y el elefante.

OBJECTIVE: Construction of mild and moderate COVID-19's semiology between patients and professionals in primary care. METHOD: Qualitative investigation in a phenomenological theoretical frame, from an epistemic justice position, settled in Catalonia, primary care settings, during the first wave of COVID-19 pandemic (April-May 2020). 15 patients and 9 professionals participated. Data collection was done through semi-structured phone interviews to patients with a microbiological confirmed diagnostic of COVID-19 and followed at primary care and semi-structured narratives of professionals. Data were triangled by the three authors. RESULTS: We described the most common symptoms (fever, cough, shortness of breath, fatigue, loss of appetite, muscular and joint pain, and high airways symptoms), those that worry them the most, hesitancy about symptoms and semiology's temporality according to the descriptions done by patients. CONCLUSIONS: Official protocols should include other symptoms as fatigue, loss of appetite, muscle and joint aches and high airways symptoms as frequent symptoms of COVID-19 attending to the stories of patients. Those unspecified symptoms can be unnoticed by patients and professionals and can delay the detection of disease and the contact tracing in primary care. It is necessary to obtain a detailed description of the symptoms and avoid translating them into pre-established medical terms that with their meaning substitute and make the patients' report invisible, turning professionals deaf and blind to a new disease and making more difficult for them to build the narration of disease.

¿La mitad de la población con diagnóstico de depresión? / Half of the population diagnosed with depression?

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