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2.
Rev Invest Clin ; 72(3): 165-177, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32584326

RESUMO

BACKGROUND: Regional information regarding the characteristics of patients with coronavirus disease (COVID)-19 is needed for a better understanding of the pandemic. OBJECTIVE: The objective of the study to describe the clinical features of COVID-19 patients diagnosed in a tertiary-care center in Mexico City and to assess differences according to the treatment setting (ambulatory vs. hospital) and to the need of intensive care (IC). METHODS: We conducted a prospective cohort, including consecutive patients with COVID-19 from February 26, 2020 to April 11, 2020. RESULTS: We identified 309 patients (140 inpatients and 169 outpatients). The median age was 43 years (interquartile range, 33-54), 59.2% men, and 18.6% healthcare workers (12.3% from our center). The median body mass index (BMI) was 29.00 kg/m2 and 39.6% had obesity. Compared to outpatients, inpatients were older, had comorbidities, cough, and dyspnea more frequently. Twenty-nine (20.7%) inpatients required treatment in the IC unit (ICU). History of diabetes (type 1 or 2) and abdominal pain were more common in ICU patients compared to non-ICU patients. ICU patients had higher BMIs, higher respiratory rates, and lower room-air capillary oxygen saturations. ICU patients showed a more severe inflammatory response as assessed by white blood cell count, neutrophil and platelet count, C-reactive protein, ferritin, procalcitonin, and albumin levels. By the end of the study period, 65 inpatients had been discharged because of improvement, 70 continued hospitalized, and five had died. CONCLUSIONS: Patients with comorbidities, either middle-age obese or elderly complaining of fever, cough, or dyspnea, were more likely to be admitted. At admission, patients with diabetes, high BMI, and clinical or laboratory findings consistent with a severe inflammatory state were more likely to require IC.


Assuntos
Betacoronavirus , Infecções por Coronavirus/epidemiologia , Pandemias , Pneumonia Viral/epidemiologia , Dor Abdominal/epidemiologia , Adulto , Idoso , Assistência Ambulatorial , Biomarcadores/sangue , Índice de Massa Corporal , COVID-19 , Comorbidade , Infecções por Coronavirus/complicações , Infecções por Coronavirus/terapia , Cuidados Críticos , Dispneia/etiologia , Feminino , Gastroenteropatias/epidemiologia , Humanos , Pacientes Internados/estatística & dados numéricos , Masculino , México , Pessoa de Meia-Idade , Obesidade/epidemiologia , Pacientes Ambulatoriais/estatística & dados numéricos , Pneumonia Viral/complicações , Pneumonia Viral/terapia , SARS-CoV-2 , Índice de Gravidade de Doença , Centros de Atenção Terciária/estatística & dados numéricos , Resultado do Tratamento
3.
Rev. invest. clín ; 72(3): 165-177, May.-Jun. 2020. tab, graf
Artigo em Inglês | LILACS | ID: biblio-1251851

RESUMO

ABSTRACT Background: Regional information regarding the characteristics of patients with coronavirus disease (COVID)-19 is needed for a better understanding of the pandemic. Objective: The objective of the study to describe the clinical features of COVID-19 patients diagnosed in a tertiary-care center in Mexico City and to assess differences according to the treatment setting (ambulatory vs. hospital) and to the need of intensive care (IC). Methods: We conducted a prospective cohort, including consecutive patients with COVID-19 from February 26, 2020 to April 11, 2020. Results: We identified 309 patients (140 inpatients and 169 outpatients). The median age was 43 years (interquartile range, 33-54), 59.2% men, and 18.6% healthcare workers (12.3% from our center). The median body mass index (BMI) was 29.00 kg/m2 and 39.6% had obesity. Compared to outpatients, inpatients were older, had comorbidities, cough, and dyspnea more frequently. Twenty-nine (20.7%) inpatients required treatment in the IC unit (ICU). History of diabetes (type 1 or 2) and abdominal pain were more common in ICU patients compared to non-ICU patients. ICU patients had higher BMIs, higher respiratory rates, and lower room-air capillary oxygen saturations. ICU patients showed a more severe inflammatory response as assessed by white blood cell count, neutrophil and platelet count, C-reactive protein, ferritin, procalcitonin, and albumin levels. By the end of the study period, 65 inpatients had been discharged because of improvement, 70 continued hospitalized, and five had died. Conclusions: Patients with comorbidities, either middle-age obese or elderly complaining of fever, cough, or dyspnea, were more likely to be admitted. At admission, patients with diabetes, high BMI, and clinical or laboratory findings consistent with a severe inflammatory state were more likely to require IC.


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Pneumonia Viral/epidemiologia , Infecções por Coronavirus/epidemiologia , Pandemias , Betacoronavirus , Índice de Gravidade de Doença , Biomarcadores/sangue , Dor Abdominal/epidemiologia , Índice de Massa Corporal , Comorbidade , Resultado do Tratamento , Cuidados Críticos , Dispneia/etiologia , Centros de Atenção Terciária/estatística & dados numéricos , Assistência Ambulatorial , Gastroenteropatias/epidemiologia , SARS-CoV-2 , COVID-19 , Pacientes Internados/estatística & dados numéricos , México , Obesidade/epidemiologia
4.
Trop Anim Health Prod ; 51(1): 165-169, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30027489

RESUMO

The aim of this study was to assess transmission of Taenia solium cysticercosis in Palmarito Arriba, a small village in the rural area of the Portuguesa state of Venezuela, through (1) an evaluation of T. solium transmission risk factors present in the community and (2) serological detection of the secreted metacestode HP10 antigen (HP10 Ag) and of anti-metacestode antibodies in sera from rural pigs. Risk factors associated with transmission of cysticercosis were the following: 100% (23/23) of the households lacked piped water, 87.0% (20/23) of households lacked latrines, 88.0% (100/114) of inhabitants routinely defecated in the open/air, 19.05% (12/63) of the interviewed population had observed proglottids in their stools. More significantly, 9/13 householders breeding pigs reported seeing proglottids in their stools. Of the 25 pigs available for bleeding and serological testing, 64% (16/25) were free roaming and 36% (9/25) were "backyard" animals; 28% (7/25) were seropositive for both the HP10 Ag and antibody, 20.0% (5/25) were seropositive for HP10 Ag alone, and 36.0% (9/25) were seropositive for antibody alone. Given this clear evidence of endemic porcine cysticercosis, further studies are needed to assess and control the level of porcine and human taeniasis and cysticercosis in this and neighboring communities.


Assuntos
Cisticercose/veterinária , Doenças dos Suínos/epidemiologia , Taenia solium/fisiologia , Animais , Anticorpos Anti-Helmínticos/sangue , Antígenos de Helmintos/sangue , Cisticercose/epidemiologia , Cisticercose/parasitologia , Cisticercose/transmissão , Feminino , Masculino , Fatores de Risco , Estudos Soroepidemiológicos , Sus scrofa , Suínos , Doenças dos Suínos/parasitologia , Doenças dos Suínos/transmissão , Venezuela/epidemiologia
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