Evolución funcional y del estado de ánimo de pacientes tras ingreso por COVID-19 en una unidad de Cuidados Intensivos / Functional evolution and mood of patients after admission for COVID-19 to intensive care unit

Objetivo: Describir la situación funcional de los pacientes al mes y a los dos meses tras el ingreso por neumonía COVID-19 en una unidad de cuidados intensivos (UCI) y afectación del estado de ánimo al mes del alta hospitalaria. Diseño: Estudio de cohortes prospectivo. Pacientes: Ingresados en UCI por neumonía COVID-19 durante los meses de febrero a julio de 2020. Variables de interés: Datos demográficos, mortalidad, estancia media en UCI y hospitalización, destino al alta, situación funcional (índice de Barthel) basal, tras el alta, al mes y a los dos meses, fisioterapia realizada y repercusión en el estado de ánimo (Escala Hospitalaria de Ansiedad y Depresión). Resultados: Ingresaron en la UCI 89 pacientes. La mortalidad en UCI fue del 48,3%. Entre los supervivientes, 42 pacientes completaron seguimiento a los dos meses. Se objetivó un deterioro funcional al alta de UCI en el 97,6% y al alta hospitalaria en el 76,2%. En el seguimiento, un 66,7% había recuperado su nivel funcional basal al mes de salida del hospital y un 85,7% lo había hecho a los dos meses. Al mes del alta, el 12% presentaban resultados compatibles con ansiedad y un 20% compatibles con depresión. Conclusiones: Los pacientes ingresados en UCI por neumonía COVID-19 presentan una mortalidad hospitalaria elevada y los supervivientes presentan un deterioro funcional severo. A los dos meses del alta, la mayoría recupera su situación funcional basal y estado emocional previos al ingreso.(AU)

Objective: Describe the functional situation of patients one and two months after admission for COVID-19 pneumonia in an intensive care unit (ICU) and affect their mood one month after hospital discharge. Design: Prospective cohort study was carried out. Patients: Patients admitted to the ICU for COVID-19 pneumonia during the months of February to July 2020.Primary variables of interest: Demographic data, mortality, ICU stay and hospital stay, destination at discharge, functional status at baseline (Barthel Index), after discharge, at one month and two months, physiotherapy treatment and impact on mood (Hospital Anxiety and Depression Scale). Results: 89 patients were admitted in ICU with a mortality rate of 48.3% in the ICU. Among the survivors, 42 patients completed the follow-up at two months. Functional deterioration was observed at ICU discharge in 97.6% and at hospital discharge in 76.2%. At follow-up, 66.7% of patients had recovered their baseline functional level one month after leaving the hospital and 85.7% had done so after two months. One month after discharge, 12% of the patients had results compatible with anxiety and 20% had results compatible with depression. Conclusions: Patients admitted to the ICU for COVID-19 pneumonia have high hospital mortality, and those who survive show severe functional deterioration after admission. Two months after hospital discharge, most survivors recover their baseline functional status and mood prior to admission.(AU)

[Functional evolution and mood of patients after admission for COVID-19 to intensive care unit]. / Evolución funcional y del estado de ánimo de pacientes tras ingreso por COVID-19 en una unidad de Cuidados Intensivos.

OBJECTIVE: Describe the functional situation of patients one and two months after admission for COVID-19 pneumonia in an intensive care unit (ICU) and affect their mood one month after hospital discharge. DESIGN: Prospective cohort study was carried out. PATIENTS: Patients admitted to the ICU for COVID-19 pneumonia during the months of February to July 2020. PRIMARY VARIABLES OF INTEREST: Demographic data, mortality, ICU stay and hospital stay, destination at discharge, functional status at baseline (Barthel Index), after discharge, at one month and two months, physiotherapy treatment and impact on mood (Hospital Anxiety and Depression Scale). RESULTS: 89 patients were admitted in ICU with a mortality rate of 48.3% in the ICU. Among the survivors, 42 patients completed the follow-up at two months. Functional deterioration was observed at ICU discharge in 97.6% and at hospital discharge in 76.2%. At follow-up, 66.7% of patients had recovered their baseline functional level one month after leaving the hospital and 85.7% had done so after two months. One month after discharge, 12% of the patients had results compatible with anxiety and 20% had results compatible with depression. CONCLUSIONS: Patients admitted to the ICU for COVID-19 pneumonia have high hospital mortality, and those who survive show severe functional deterioration after admission. Two months after hospital discharge, most survivors recover their baseline functional status and mood prior to admission.

A reply to "Relevant factors in the eutrophication of the Uruguay River and the Río Negro".

A recent paper by Beretta-Blanco and Carrasco-Letelier (2021) claims that agricultural eutrophication is not one of the main causes for cyanobacterial blooms in rivers and artificial reservoirs. By combining rivers of markedly different hydrological characteristics e.g., presence/absence and number of dams, river discharge and geological setting, the study speculates about the role of nutrients for modulating phytoplankton chlorophyll-a. Here, we identified serious flaws, from erratic and inaccurate data manipulation. The study did not define how erroneous original dataset values were treated, how the variables below the detection/quantification limit were numerically introduced, lack of mandatory variables for river studies such as flow and rainfall, arbitrary removal of pH > 7.5 values (which were not outliers), and finally how extreme values of other environmental variables were included. In addition, we identified conceptual and procedural mistakes such as biased construction/evaluation of model prediction capability. The study trained the model using pooled data from a short restricted lotic section of the (large) Uruguay River and from both lotic and reservoir domains of the Negro River, but then tested predictability within the (small) Cuareim River. Besides these methodological considerations, the article shows misinterpretations of the statistical correlation of cause and effect neglecting basic limnological knowledge of the ecology of harmful algal blooms (HABs) and international research on land use effects on freshwater quality. The argument that pH is a predictor variable for HABs neglects overwhelming basic paradigms of carbon fluxes and change in pH because of primary productivity. As a result, the article introduces the notion that HABs formation are not related to agricultural land use and water residence time and generate a great risk for the management of surface waterbodies. This reply also emphasizes the need for good practices of open data management, especially for public databases in view of external reproducibility.