Impact of New Onset Atrial Fibrillation in Hospitalized Patients with COVID-19. Results of the "ACO-VID" Registry.

OBJECTIVE: To assess the impact of new-onset atrial fibrillation (AF) on patients hospitalized with coronavirus disease 2019 (COVID-19). METHODS: Multicenter and retrospective study that included subjects >55 years hospitalized with COVID-19 from March to October 2020 in Spanish hospitals. Patients were divided into 3 groups (no AF, new-onset AF, and preexisting AF) and followed-up to 90 days. RESULTS: A total of 668 patients were included, of whom 162 (24.3%) had no AF, 107 (16.0%) new-onset AF and 399 (59.7%) preexisting AF. Compared to patients without AF, those patients with new-onset AF were older and had more comorbidities, but without differences with preexisting AF. During hospitalization, in the univariate analysis, compared to patients without AF, major bleeding and cardiovascular mortality were more frequent in patients with new-onset AF (10.3% vs 0.6%; P < .001; 2.8% vs 0.6%; P = .025, respectively), with a trend toward more stroke (1.9% vs 0%; P = .085). Outcomes were similar between AF groups, but the length of stay was greater in preexisting AF patients. Among patients with new-onset AF taking reduced doses of anticoagulant treatment was associated with higher risks of stroke and major bleeding. CONCLUSIONS: In COVID-19 hospitalized patients, new-onset AF may be associated with worse outcomes, but influenced by the dose of anticoagulants.

Impact of atrial fibrillation and anticoagulation on the risk of death, thromboembolic disease and bleeding in patients with COVID-19: the ACO-VID Registry.

OBJECTIVE: To describe the clinical profile, risk of complications and impact of anticoagulation in COVID-19 hospitalized patients, according to the presence of atrial fibrillation (AF). METHODS: Multicenter, retrospective, and observational study that consecutively included patients >55 years admitted with COVID-19 from March to October 2020. In AF patients, anticoagulation was chosen based on clinicians' judgment. Patients were followed-up for 90 days. RESULTS: A total of 646 patients were included, of whom 75.2% had AF. Overall, mean age was 75 ± 9.1 years and 62.4% were male. Patients with AF were older and had more comorbidities. The most common anticoagulants used during hospitalization in patients with AF were edoxaban (47.9%), low molecular weight heparin (27.0%), and dabigatran (11.7%) and among patients without AF, these numbers were 0%, 93.8% and 0%. Overall, during the study period (68 ± 3 days), 15.2% of patients died, 8.2% of patients presented a major bleeding and 0.9% had a stroke/systemic embolism. During hospitalization, patients with AF had a higher risk of major bleeding (11.3% vs 0.7%; p < .01), COVID-19-related deaths (18.0% vs 4.5%; p = .02), and all-cause deaths (20.6% vs 5.6%; p = .02). Age (HR 1.5; 95% CI 1.0-2.3) and elevated transaminases (HR 3.5; 95% CI 2.0-6.1) were independently associated with all-cause mortality. AF was independently associated with major bleeding (HR 2.2; 95% CI 1.1-5.3). CONCLUSIONS: Among patients hospitalized with COVID-19, patients with AF were older, had more comorbidities and had a higher risk of major bleeding. Age and elevated transaminases during hospitalization, but not AF nor anticoagulant treatment increased the risk of all-cause death.

Programas de detección precoz de la hipoacusia infantil en España: estado de la cuestión / Early Detection Programmes for Child Hearing Loss in Spain: Current Practices

ANTECEDENTES Y OBJETIVO: En 2003, el Ministerio de Sanidad y Consumo, junto con las comunidades autónomas (CCAA), aprobaron el documento sobre los contenidos básicos y mínimos para el establecimiento de Programas de detección precoz de la sordera, y desde entonces la Comisión para la detección precoz de la hipoacusia (CODEPEH) ha llevado a cabo varias actualizaciones y recomendaciones de mejora de estos programas. El objetivo de este trabajo es realizar un estudio comparativo de cómo han plasmado las CCAA, en sus Programas de detección precoz de la sordera, las recomendaciones realizadas por la CODEPEH hasta 2017. MATERIAL Y MÉTODO: Se han revisado los programas (o documentos afines) de 16 CCAA disponibles en línea o en papel. RESULTADOS: Las 16 estrategias de detección precoz analizadas son diferentes, ya sea en el número de pruebas a realizar, ya sea en los tiempos en los que se llevan a cabo o las técnicas empleadas. Más de un tercio de estos programas fueron editados antes del 2010 y no han sido actualizados. Las otoemisiones acústicas es la técnica elegida como primera prueba de cribado en 9 de las 16 CCAA. Solo una comunidad incorpora la realización de la prueba de reacción en cadena de la polimerasa en saliva para citomegalovirus en niños con prueba de cribado alterada. CONCLUSIONES: Todas las CCAA realizan cribado auditivo, pero la gran diversidad entre programas dificulta sacar conclusiones fiables sobre el resultado final del mismo y sería necesario tender a una unificación con la elaboración de un programa nacional y una base de datos común

INTRODUCTION AND OBJECTIVE: In 2003, The Ministry of Health and Consumption, together with the Autonomous Communities (CCAA), approved a minimum and basic document concerning the establishment of Early Hearing Detection and Intervention State Programmes. Since then, the Commission for the early detection of hearing loss (CODEPEH) has made several updates and recommendations to improve these programmes. The objective of this study is to carry out a comparative analysis of how the CCAA established their Early Hearing Detection and Intervention programs and if they integrate the recommendations made by CODEPEH until 2017. MATERIAL AND METHOD: The programmes (or related documents) of 16 CCAA available on line or paper are reviewed. RESULTS: The 16 Early Hearing Detection and Intervention strategies analyzed are different, either in the number of test to be performed, the time in which they are performed or the techniques used. More than a third of these programmes were published before 2010 and have not been updated. Otoacoustic emissions is the chosen technique as the first screening test in nine of the 16 CCAA. Only one CCAA incorporates the salivary polymerase chain reaction test for cytomegalovirus in children with altered screening test. CONCLUSION: All CCAA perform Early Hearing Detection and Intervention programmes but the heterogeneity does not allow drawing reliable conclusions about the result of the screening process and it would be necessary to aim for unification with the elaboration of a national programme and an integrated general database

Early Detection Programmes for Child Hearing Loss in Spain: Current Practices. / Programas de detección precoz de la hipoacusia infantil en España: estado de la cuestión.

INTRODUCTION AND OBJECTIVE: In 2003, The Ministry of Health and Consumption, together with the Autonomous Communities (CCAA), approved a minimum and basic document concerning the establishment of Early Hearing Detection and Intervention State Programmes. Since then, the Commission for the early detection of hearing loss (CODEPEH) has made several updates and recommendations to improve these programmes. The objective of this study is to carry out a comparative analysis of how the CCAA established their Early Hearing Detection and Intervention programs and if they integrate the recommendations made by CODEPEH until 2017. MATERIAL AND METHOD: The programmes (or related documents) of 16 CCAA available on line or paper are reviewed RESULTS: The 16 Early Hearing Detection and Intervention strategies analyzed are different, either in the number of test to be performed, the time in which they are performed or the techniques used. More than a third of these programmes were published before 2010 and have not been updated. Otoacoustic emissions is the chosen technique as the first screening test in nine of the 16 CCAA. Only one CCAA incorporates the salivary polymerase chain reaction test for cytomegalovirus in children with altered screening test. CONCLUSION: All CCAA perform Early Hearing Detection and Intervention programmes but the heterogeneity does not allow drawing reliable conclusions about the result of the screening process and it would be necessary to aim for unification with the elaboration of a national programme and an integrated general database.