RESUMO
The early detection of symptoms and rapid testing are the basis of an efficient screening strategy to control COVID-19 transmission. The olfactory dysfunction is one of the most prevalent symptom and in many cases is the first symptom. This study aims to develop a machine learning COVID-19 predictive tool based on symptoms and a simple olfactory test, which consists of identifying the smell of an aromatized hydroalcoholic gel. A multi-centre population-based prospective study was carried out in the city of Reus (Catalonia, Spain). The study included consecutive patients undergoing a reverse transcriptase polymerase chain reaction test for presenting symptoms suggestive of COVID-19 or for being close contacts of a confirmed COVID-19 case. A total of 519 patients were included, 386 (74.4%) had at least one symptom and 133 (25.6%) were asymptomatic. A classification tree model including sex, age, relevant symptoms and the olfactory test results obtained a sensitivity of 0.97 (95% CI 0.91-0.99), a specificity of 0.39 (95% CI 0.34-0.44) and an AUC of 0.87 (95% CI 0.83-0.92). This shows that this machine learning predictive model is a promising mass screening for COVID-19.
Assuntos
COVID-19 , Olfato , COVID-19/diagnóstico , Humanos , Aprendizado de Máquina , Programas de Rastreamento , Estudos ProspectivosRESUMO
Many countries have seen a two-wave pattern in reported cases of coronavirus disease-19 during the 2020 pandemic, with a first wave during spring followed by the current second wave in late summer and autumn. Empirical data show that the characteristics of the effects of the virus do vary between the two periods. Differences in age range and severity of the disease have been reported, although the comparative characteristics of the two waves still remain largely unknown. Those characteristics are compared in this study using data from two equal periods of 3 and a half months. The first period, between 15th March and 30th June, corresponding to the entire first wave, and the second, between 1st July and 15th October, corresponding to part of the second wave, still present at the time of writing this article. Two hundred and four patients were hospitalized during the first period, and 264 during the second period. Patients in the second wave were younger and the duration of hospitalization and case fatality rate were lower than those in the first wave. In the second wave, there were more children, and pregnant and post-partum women. The most frequent signs and symptoms in both waves were fever, dyspnea, pneumonia, and cough, and the most relevant comorbidities were cardiovascular diseases, type 2 diabetes mellitus, and chronic neurological diseases. Patients from the second wave more frequently presented renal and gastrointestinal symptoms, were more often treated with non-invasive mechanical ventilation and corticoids, and less often with invasive mechanical ventilation, conventional oxygen therapy and anticoagulants. Several differences in mortality risk factors were also observed. These results might help to understand the characteristics of the second wave and the behaviour and danger of SARS-CoV-2 in the Mediterranean area and in Western Europe. Further studies are needed to confirm our findings.
Assuntos
COVID-19/epidemiologia , COVID-19/terapia , Hospitalização/estatística & dados numéricos , Idoso , Comorbidade , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pandemias , Espanha/epidemiologia , Resultado do TratamentoRESUMO
Para determinar la distribución porcentual y las características epidemiológicas de los casos de Dengue Hemorrágico en el Hospital de San Antonio del Táchira, región suroeste andina de Venezuela, en la frontera con Colombia, se revisaron 65 historias de todos los pacientes hospitalizados en ese centro asistencial, desde junio de 1991 hasta junio de 1992, con el anterior diagnóstico según los criterios de la Organización Mundial de la Salud (OMS). Las variables estudiadas fueron: edad, sexo, procedencia, manifestaciones clínicas y alteraciones en las pruebas de laboratorio. El mayor porcentaje de los casos correspondió al grupo de pacientes menores de cinco años, predominando el sexo masculino, con procedencia predominante del área urbana. Las principales manifestaciones clínicas fueron: fiebre, decaimiento y cefalea. Petequias, equimosis y epistaxis, fueron las principales manifestaciones hemorrágicas. La "prueba del torniquete" fue positiva en el 77 por ciento de los casos. Predominó la enfermedad en los meses de junio a diciembre, con un pico máximo en agosto. El Dengue Hemorrágico en el área de San Antonio del Táchira siguió un comportamiento particular no visto en otras series, cuya causa requiere de estudios adicionales.