27 results on '"Pérez, Carmen"'
Search Results
2. WHO Ordinal Scale and Inflammation Risk Categories in COVID-19. Comparative Study of the Severity Scales.
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Rubio-Rivas M, Mora-Luján JM, Formiga F, Arévalo-Cañas C, Lebrón Ramos JM, Villalba García MV, Fonseca Aizpuru EM, Díez-Manglano J, Arnalich Fernández F, Romero Cabrera JL, García García GM, Pesqueira Fontan PM, Vargas Núñez JA, Freire Castro SJ, Loureiro Amigo J, Pascual Pérez MLR, Alcalá Pedrajas JN, Encinas-Sánchez D, Mella Pérez C, Ena J, Gracia Gutiérrez A, Esteban Giner MJ, Varona JF, Millán Núñez-Cortés J, and Casas-Rojo JM
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- Humans, Inflammation diagnosis, Retrospective Studies, SARS-CoV-2, Treatment Outcome, World Health Organization, COVID-19 diagnosis
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Background: The WHO ordinal severity scale has been used to predict mortality and guide trials in COVID-19. However, it has its limitations., Objective: The present study aims to compare three classificatory and predictive models: the WHO ordinal severity scale, the model based on inflammation grades, and the hybrid model., Design: Retrospective cohort study with patient data collected and followed up from March 1, 2020, to May 1, 2021, from the nationwide SEMI-COVID-19 Registry. The primary study outcome was in-hospital mortality. As this was a hospital-based study, the patients included corresponded to categories 3 to 7 of the WHO ordinal scale. Categories 6 and 7 were grouped in the same category., Key Results: A total of 17,225 patients were included in the study. Patients classified as high risk in each of the WHO categories according to the degree of inflammation were as follows: 63.8% vs. 79.9% vs. 90.2% vs. 95.1% (p<0.001). In-hospital mortality for WHO ordinal scale categories 3 to 6/7 was as follows: 0.8% vs. 24.3% vs. 45.3% vs. 34% (p<0.001). In-hospital mortality for the combined categories of ordinal scale 3a to 5b was as follows: 0.4% vs. 1.1% vs. 11.2% vs. 27.5% vs. 35.5% vs. 41.1% (p<0.001). The predictive regression model for in-hospital mortality with our proposed combined ordinal scale reached an AUC=0.871, superior to the two models separately., Conclusions: The present study proposes a new severity grading scale for COVID-19 hospitalized patients. In our opinion, it is the most informative, representative, and predictive scale in COVID-19 patients to date., (© 2022. The Author(s), under exclusive licence to Society of General Internal Medicine.)
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- 2022
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3. Effects of COVID-19 lockdown on the dietary habits and lifestyle in a population in southern Spain: a cross-sectional questionnaire.
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Navarro-Pérez CF, Fernández-Aparicio Á, González-Jiménez E, Montero-Alonso MÁ, and Schmidt-RioValle J
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- Adolescent, Communicable Disease Control, Cross-Sectional Studies, Feeding Behavior, Humans, Life Style, Pandemics, Spain epidemiology, Surveys and Questionnaires, COVID-19 epidemiology
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Background/objective: Few studies have assessed the effect of lockdown on physical activity and eating behaviours in a population from the Autonomous Community of Andalusia in southern Spain. The aim of our study was to describe the effect of COVID-19 pandemic home lockdown on eating habits and lifestyle in the Andalusian population., Subjects/methods: A cross-sectional observational study was carried out on a population from southern Spain, Andalusian population. An online questionnaire was shared through social networks and snowball sampling. A total of 1140 people filled in the questionnaire. The questionnaire consisted of 34 items classified into three sections: sociodemographic data, work and leisure activities and questions on food consumption. Each item offered pre- and post-lockdown information., Results: The participants were classified into three age groups: 18-35, 36-65 and over 65. Statistically significant differences were found between the three groups, with the younger age group undergoing greater changes, increasing their physical activity and consumption of fresh food, and decreasing both their consumption of fast food at home and alcohol intake., Conclusions: These findings suggest that, in the current social and health crisis, the citizens of southern Spain have become aware of the importance of maintaining an appropriate lifestyle to remain healthy, particularly the younger population with less well-consolidated habits., (© 2021. The Author(s), under exclusive licence to Springer Nature Limited.)
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- 2022
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4. Clusters of inflammation in COVID-19: descriptive analysis and prognosis on more than 15,000 patients from the Spanish SEMI-COVID-19 Registry.
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Rubio-Rivas M, Mora-Luján JM, Formiga F, Corrales González MÁ, García Andreu MDM, Moreno-Torres V, García García GM, Alcalá Pedrajas JN, Boixeda R, Pérez-Lluna L, Cortés-Rodríguez B, Mella-Pérez C, Navas Alcántara MS, López Reboiro ML, Alfaro-Lara V, Pérez-Martín S, Martín-Oterino JÁ, Gracia Gutiérrez A, Martín-Urda Díez-Canseco A, Comas Casanova P, Pérez García C, Varona JF, Gómez-Huelgas R, Antón-Santos JM, and Lumbreras-Bermejo C
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- Biomarkers, Ferritins, Humans, Inflammation, Prognosis, Registries, Retrospective Studies, SARS-CoV-2, COVID-19 complications, Lymphopenia
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Uncontrolled inflammation following COVID-19 infection is an important characteristic of the most seriously ill patients. The present study aims to describe the clusters of inflammation in COVID-19 and to analyze their prognostic role. This is a retrospective observational study including 15,691 patients with a high degree of inflammation. They were included in the Spanish SEMI-COVID-19 registry from March 1, 2020 to May 1, 2021. The primary outcome was in-hospital mortality. Hierarchical cluster analysis identified 7 clusters. C1 is characterized by lymphopenia, C2 by elevated ferritin, and C3 by elevated LDH. C4 is characterized by lymphopenia plus elevated CRP and LDH and frequently also ferritin. C5 is defined by elevated CRP, and C6 by elevated ferritin and D-dimer, and frequently also elevated CRP and LDH. Finally, C7 is characterized by an elevated D-dimer. The clusters with the highest in-hospital mortality were C4, C6, and C7 (17.4% vs. 18% vs. 15.6% vs. 36.8% vs. 17.5% vs. 39.3% vs. 26.4%). Inflammation clusters were found as independent factors for in-hospital mortality. In detail and, having cluster C1 as reference, the model revealed a worse prognosis for all other clusters: C2 (OR = 1.30, p = 0.001), C3 (OR = 1.14, p = 0.178), C4 (OR = 2.28, p < 0.001), C5 (OR = 1.07, p = 0.479), C6 (OR = 2.29, p < 0.001), and C7 (OR = 1.28, p = 0.001). We identified 7 groups based on the presence of lymphopenia, elevated CRP, LDH, ferritin, and D-dimer at the time of hospital admission for COVID-19. Clusters C4 (lymphopenia + LDH + CRP), C6 (ferritin + D-dimer), and C7 (D-dimer) had the worst prognosis in terms of in-hospital mortality., (© 2022. The Author(s), under exclusive licence to Società Italiana di Medicina Interna (SIMI).)
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- 2022
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5. Clinical Features and Risk Factors for Mortality Among Long-term Care Facility Residents Hospitalized Due to COVID-19 in Spain.
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Ramos-Rincón JM, Bernabeu-Wittel M, Fiteni-Mera I, López-Sampalo A, López-Ríos C, García-Andreu MD, Mancebo-Sevilla JJ, Jiménez-Juan C, Matía-Sanz M, López-Quirantes P, Rubio-Rivas M, Paredes-Ruiz D, González-San-Narciso C, González-Vega R, Sanz-Espinosa P, Hernández-Milián A, Gonzalez-Noya A, Gil-Sánchez R, Boixeda R, Alcalá-Pedrajas JN, Palop-Cervera M, Cortés-Rodríguez B, Guisado-Espartero ME, Mella-Pérez C, and Gómez-Huelgas R
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- Aged, Cross-Sectional Studies, Female, Hospitalization, Humans, Long-Term Care, Male, Retrospective Studies, Risk Factors, Spain epidemiology, COVID-19
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Background: COVID-19 severely impacted older adults and long-term care facility (LTCF) residents. Our primary aim was to describe differences in clinical and epidemiological variables, in-hospital management, and outcomes between LTCF residents and community-dwelling older adults hospitalized with COVID-19. The secondary aim was to identify risk factors for mortality due to COVID-19 in hospitalized LTCF residents., Methods: This is a cross-sectional analysis within a retrospective cohort of hospitalized patients ≥75 years with confirmed COVID-19 admitted to 160 Spanish hospitals. Differences between groups and factors associated with mortality among LTCF residents were assessed through comparisons and logistic regression analysis., Results: Of 6 189 patients ≥75 years, 1 185 (19.1%) were LTCF residents and 4 548 (73.5%) were community-dwelling. LTCF residents were older (median: 87.4 vs 82.1 years), mostly female (61.6% vs 43.2%), had more severe functional dependence (47.0% vs 7.8%), more comorbidities (Charlson Comorbidity Index: 6 vs 5), had dementia more often (59.1% vs 14.4%), and had shorter duration of symptoms (median: 3 vs 6 days) than community-dwelling patients (all, p < .001). Mortality risk factors in LTCF residents were severe functional dependence (adjusted odds ratios [aOR]: 1.79; 95% confidence interval [CI]: 1.13-2.83; p = .012), dyspnea (1.66; 1.16-2.39; p = .004), SatO2 < 94% (1.73; 1.27-2.37; p = .001), temperature ≥ 37.8°C (1.62; 1.11-2.38; p = .013); qSOFA index ≥ 2 (1.62; 1.11-2.38; p = .013), bilateral infiltrates (1.98; 1.24-2.98; p < .001), and high C-reactive protein (1.005; 1.003-1.007; p < .001). In-hospital mortality was initially higher among LTCF residents (43.3% vs 39.7%), but lower after adjusting for sex, age, functional dependence, and comorbidities (aOR: 0.74, 95%CI: 0.62-0.87; p < .001)., Conclusion: Basal functional status and COVID-19 severity are risk factors of mortality in LTCF residents. The lower adjusted mortality rate in LTCF residents may be explained by earlier identification, treatment, and hospitalization for COVID-19., (© The Author(s) 2021. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)
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- 2022
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6. Deploying unsupervised clustering analysis to derive clinical phenotypes and risk factors associated with mortality risk in 2022 critically ill patients with COVID-19 in Spain.
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Rodríguez A, Ruiz-Botella M, Martín-Loeches I, Jimenez Herrera M, Solé-Violan J, Gómez J, Bodí M, Trefler S, Papiol E, Díaz E, Suberviola B, Vallverdu M, Mayor-Vázquez E, Albaya Moreno A, Canabal Berlanga A, Sánchez M, Del Valle Ortíz M, Ballesteros JC, Martín Iglesias L, Marín-Corral J, López Ramos E, Hidalgo Valverde V, Vidaur Tello LV, Sancho Chinesta S, Gonzáles de Molina FJ, Herrero García S, Sena Pérez CC, Pozo Laderas JC, Rodríguez García R, Estella A, and Ferrer R
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- Aged, Cluster Analysis, Critical Illness, Female, Humans, Male, Middle Aged, Phenotype, Risk Assessment, Risk Factors, Spain epidemiology, COVID-19 mortality, COVID-19 therapy
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Background: The identification of factors associated with Intensive Care Unit (ICU) mortality and derived clinical phenotypes in COVID-19 patients could help for a more tailored approach to clinical decision-making that improves prognostic outcomes., Methods: Prospective, multicenter, observational study of critically ill patients with confirmed COVID-19 disease and acute respiratory failure admitted from 63 ICUs in Spain. The objective was to utilize an unsupervised clustering analysis to derive clinical COVID-19 phenotypes and to analyze patient's factors associated with mortality risk. Patient features including demographics and clinical data at ICU admission were analyzed. Generalized linear models were used to determine ICU morality risk factors. The prognostic models were validated and their performance was measured using accuracy test, sensitivity, specificity and ROC curves., Results: The database included a total of 2022 patients (mean age 64 [IQR 5-71] years, 1423 (70.4%) male, median APACHE II score (13 [IQR 10-17]) and SOFA score (5 [IQR 3-7]) points. The ICU mortality rate was 32.6%. Of the 3 derived phenotypes, the A (mild) phenotype (537; 26.7%) included older age (< 65 years), fewer abnormal laboratory values and less development of complications, B (moderate) phenotype (623, 30.8%) had similar characteristics of A phenotype but were more likely to present shock. The C (severe) phenotype was the most common (857; 42.5%) and was characterized by the interplay of older age (> 65 years), high severity of illness and a higher likelihood of development shock. Crude ICU mortality was 20.3%, 25% and 45.4% for A, B and C phenotype respectively. The ICU mortality risk factors and model performance differed between whole population and phenotype classifications., Conclusion: The presented machine learning model identified three clinical phenotypes that significantly correlated with host-response patterns and ICU mortality. Different risk factors across the whole population and clinical phenotypes were observed which may limit the application of a "one-size-fits-all" model in practice.
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- 2021
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7. Clinical Characteristics and Prognosis of COPD Patients Hospitalized with SARS-CoV-2.
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Gómez Antúnez M, Muiño Míguez A, Bendala Estrada AD, Maestro de la Calle G, Monge Monge D, Boixeda R, Ena J, Mella Pérez C, Anton Santos JM, and Lumbreras Bermejo C
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- Aged, COVID-19 mortality, Female, Humans, Male, Pandemics, Pneumonia, Viral complications, Pneumonia, Viral mortality, Pneumonia, Viral therapy, Pneumonia, Viral virology, Prognosis, Pulmonary Disease, Chronic Obstructive mortality, Registries, Retrospective Studies, Risk Factors, SARS-CoV-2, Spain epidemiology, Survival Rate, COVID-19 complications, COVID-19 therapy, Pulmonary Disease, Chronic Obstructive complications, Pulmonary Disease, Chronic Obstructive therapy
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Objective: To describe the characteristics and prognosis of patients with COPD admitted to the hospital due to SARS-CoV-2 infection., Methods: The SEMI-COVID registry is an ongoing retrospective cohort comprising consecutive COVID-19 patients hospitalized in Spain since the beginning of the pandemic in March 2020. Data on demographics, clinical characteristics, comorbidities, laboratory tests, radiology, treatment, and progress are collected. Patients with COPD were selected and compared to patients without COPD. Factors associated with a poor prognosis were analyzed., Results: Of the 10,420 patients included in the SEMI-COVID registry as of May 21, 2020, 746 (7.16%) had a diagnosis of COPD. Patients with COPD are older than those without COPD (77 years vs 68 years) and more frequently male. They have more comorbidities (hypertension, hyperlipidemia, diabetes mellitus, atrial fibrillation, heart failure, ischemic heart disease, peripheral vascular disease, kidney failure) and a higher Charlson Comorbidity Index (2 vs 1, p<0.001). The mortality rate in COPD patients was 38.3% compared to 19.2% in patients without COPD (p<0.001). Male sex, a history of hypertension, heart failure, moderate-severe chronic kidney disease, presence of cerebrovascular disease with sequelae, degenerative neurological disease, dementia, functional dependence, and a higher Charlson Comorbidity Index have been associated with increased mortality due to COVID-19 in COPD patients. Survival was higher among patients with COPD who were treated with hydroxychloroquine (87.1% vs 74.9%, p<0.001) and with macrolides (57.9% vs 50%, p<0.037). Neither prone positioning nor non-invasive mechanical ventilation, high-flow nasal cannula, or invasive mechanical ventilation were associated with a better prognosis., Conclusion: COPD patients admitted to the hospital with SARS-CoV-2 infection have more severe disease and a worse prognosis than non-COPD patients., Competing Interests: The authors declare that they have no conflicts of interest for this work., (© 2020 Gómez Antúnez et al.)
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- 2021
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8. Does admission acetylsalicylic acid uptake in hospitalized COVID-19 patients have a protective role? Data from the Spanish SEMI-COVID-19 Registry
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Formiga, Francesc, Rubio-Rivas, Manuel, Mora-Luján, José María, Escudero, Samara Campos, Martinez, Rosa Fernandez Madera, Mendez-Bailón, Manuel, Campo, Pedro Durán-del, Pérez, Andrea Riaño, García-Sánchez, Francisco-Javier, Alcalá-Pedrajas, José Nicolás, Hernández, Sergio Arnedo, Milian, Almudena Hernández, Díez, Ana Latorre, Sánchez, Ricardo Gil, Boixeda, Ramon, Vicente, Julio, Cortes, Begoña, Pérez, Carmen Mella, Espartero, María Esther Guisado, Castro, José López, Suárez, Santiago Rodríguez, Varona, Jose F., Gomez-Huelgas, Ricardo, and Ramos-Rincón, Jose Manuel
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- 2022
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9. The Use of Corticosteroids or Tocilizumab in COVID-19 Based on Inflammatory Markers
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Rubio-Rivas, Manuel, Mora-Luján, José M., Montero, Abelardo, Aguilar García, Josefa Andrea, Méndez Bailón, Manuel, Fernández Cruz, Ana, Oriol, Isabel, Teigell-Muñoz, Francisco-Javier, Dendariena Borque, Beatriz, De la Peña Fernández, Andrés, Fernández González, Raquel, Gil Sánchez, Ricardo, Fernández Fernández, Javier, Catalán, Marta, Cortés-Rodríguez, Begoña, Mella Pérez, Carmen, Montero Rivas, Lorena, Suárez Fuentetaja, Rebeca, Ternero Vega, Jara Eloísa, Ena, Javier, Martin-Urda Díez-Canseco, Anabel, Pérez García, Cristina, Varona, José F., Casas-Rojo, José Manuel, and Millán Núñez-Cortés, Jesús
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- 2022
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10. Whole Sequencing and Detailed Analysis of SARS-CoV-2 Genomes in Southeast Spain: Identification of Recurrent Mutations in the 20E (EU1) Variant with Some Clinical Implications.
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López-Andreo, María José, Vicente-Romero, María Rosario, Bernal, Enrique, Navarro-González, Inmaculada, Salazar-Martínez, Francisco, Cánovas-Cánovas, Vanesa, Gil-Ortuño, Cristina, Riquelme-Rocamora, María Gema, Solano, Francisco, Ibáñez-López, Francisco Javier, Tomás, Cristina, Candel-Pérez, Carmen, Pérez-Parra, Santiago, and Flores-Flores, César
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NUCLEOTIDE sequencing ,COVID-19 pandemic ,SARS-CoV-2 ,COVID-19 ,GENOMES ,SEQUENCE analysis - Abstract
During the COVID-19 pandemic caused by SARS-CoV-2, new waves have been associated with new variants and have the potential to escape vaccinations. Therefore, it is useful to conduct retrospective genomic surveillance research. Herein, we present a detailed analysis of 88 SARS-CoV-2 genomes belonging to samples taken from COVID-19 patients from October 2020 to April 2021 at the "Reina Sofía" Hospital (Murcia, Spain) focused to variant appeared later. The results at the mentioned stage show the turning point since the 20E (EU1) variant was still prevalent (71.6%), but Alpha was bursting to 14.8%. Concern mutations have been found in 5 genomes classified as 20E (EU1), which were not characteristic of this still little evolved variant. Most of those mutations are found in the spike protein, namely Δ69–70, E484K, Q675H and P681H. However, a relevant deletion in ORF1a at positions 3675–3677 was also identified. These mutations have been reported in many later SARS-CoV-2 lineages, including Omicron. Taken together, our data suggest that preferential emergence mutations could already be present in the early converging evolution. Aside from this, the molecular information has been contrasted with clinical data. Statistical analyses suggest that the correlation between age and severity criteria is significantly higher in the viral samples with more accumulated changes. [ABSTRACT FROM AUTHOR]
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- 2023
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11. Clinical Features and Risk Factors for Mortality Among Long-term Care Facility Residents Hospitalized Due to COVID-19 in Spain
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Ramos-Rincón, José-Manuel, Bernabeu-Wittel, Máximo, Fiteni-Mera, Isabel, López-Sampalo, Almudena, López-Ríos, Carmen, García-Andreu, María-Del-Mar, Mancebo-Sevilla, Juan-José, Jiménez-Juan, Carlos, Matía-Sanz, Marta, López-Quirantes, Pablo, Rubio-Rivas, Manuel, Paredes-Ruiz, Diana, González-San-Narciso, Candela, González-Vega, Rocío, Sanz-Espinosa, Pablo, Hernández-Milián, Almudena, Gonzalez-Noya, Amara, Gil-Sánchez, Ricardo, Boixeda, Ramon, Alcalá-Pedrajas, José-Nicolás, Palop-Cervera, Marta, Cortés-Rodríguez, Begoña, Guisado-Espartero, María-Esther, Mella-Pérez, Carmen, Gómez-Huelgas, Ricardo, and SEMI-COVID-19 Network
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Male ,Aging ,medicine.medical_specialty ,Coronavirus disease 2019 (COVID-19) ,Epidemiology ,Nursing homes ,Logistic regression ,Risk Factors ,Internal medicine ,medicine ,Humans ,Dementia ,Mortality ,Aged ,Retrospective Studies ,business.industry ,Mortality rate ,COVID-19 ,Retrospective cohort study ,medicine.disease ,Long-Term Care ,Hospitalization ,Long-term care ,Cross-Sectional Studies ,Risk factors ,Spain ,COVID-19, epidemiology, mortality, nursing homes, risk factors ,Female ,Functional status ,Geriatrics and Gerontology ,business - Abstract
Background COVID-19 severely impacted older adults and long-term care facility (LTCF) residents. Our primary aim was to describe differences in clinical and epidemiological variables, in-hospital management, and outcomes between LTCF residents and community-dwelling older adults hospitalized with COVID-19. The secondary aim was to identify risk factors for mortality due to COVID-19 in hospitalized LTCF residents. Methods This is a cross-sectional analysis within a retrospective cohort of hospitalized patients ≥75 years with confirmed COVID-19 admitted to 160 Spanish hospitals. Differences between groups and factors associated with mortality among LTCF residents were assessed through comparisons and logistic regression analysis. Results Of 6 189 patients ≥75 years, 1 185 (19.1%) were LTCF residents and 4 548 (73.5%) were community-dwelling. LTCF residents were older (median: 87.4 vs 82.1 years), mostly female (61.6% vs 43.2%), had more severe functional dependence (47.0% vs 7.8%), more comorbidities (Charlson Comorbidity Index: 6 vs 5), had dementia more often (59.1% vs 14.4%), and had shorter duration of symptoms (median: 3 vs 6 days) than community-dwelling patients (all, p < .001). Mortality risk factors in LTCF residents were severe functional dependence (adjusted odds ratios [aOR]: 1.79; 95% confidence interval [CI]: 1.13–2.83; p = .012), dyspnea (1.66; 1.16–2.39; p = .004), SatO2 < 94% (1.73; 1.27–2.37; p = .001), temperature ≥ 37.8°C (1.62; 1.11–2.38; p = .013); qSOFA index ≥ 2 (1.62; 1.11–2.38; p = .013), bilateral infiltrates (1.98; 1.24–2.98; p < .001), and high C-reactive protein (1.005; 1.003–1.007; p < .001). In-hospital mortality was initially higher among LTCF residents (43.3% vs 39.7%), but lower after adjusting for sex, age, functional dependence, and comorbidities (aOR: 0.74, 95%CI: 0.62–0.87; p < .001). Conclusion Basal functional status and COVID-19 severity are risk factors of mortality in LTCF residents. The lower adjusted mortality rate in LTCF residents may be explained by earlier identification, treatment, and hospitalization for COVID-19.
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- 2021
12. Impacto del confinamiento domiciliario durante la pandemia COVID-19 en seis parejas andaluzas: estresores, oportunidades, pareja como apoyo y post-confinamiento. Un estudio cualitativo a través de grupos focales
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Arroyo Pérez, Carmen María and Blanco Ruiz, M. Soledad
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Strengths ,Post-lockdown ,COVID-19 ,Relaciones de pareja ,Stress ,Lockdown experiences ,Experiencias confinamiento ,Fortalezas ,Apoyo ,Qualitative study ,Support ,Estudio cualitativo ,Couple relations ,Estrés - Abstract
Premio extraordinario de Trabajo Fin de Máster curso curso 2020/2021. Máster en Psicología General Sanitaria Introducción: La pandemia COVID-19 y el confinamiento domiciliario han transformado la vida diaria de las personas, modificando las relaciones sociales y familiares, produciendo alteraciones en la vida en pareja, por lo que ha presentado un desafío no solo para la salud mental individual sino también para la relacional. Objetivo: Explorar y describir cómo ha sido la experiencia de confinamiento domiciliario para las parejas, comprobando los aspectos comunes y diferenciales en función del género y de tener o no hijos/as. Método: Se seleccionó una metodología cualitativa, empleando el grupo focal para la recopilación de datos. Se empleó el muestreo intencional no probabilístico para la selección de la muestra, la cual estaba compuesta por 6 parejas andaluzas. Estas fueron distribuidas en 4 grupos focales, en función del género y de tener o no hijos/as. Las sesiones se llevaron a cabo en formato de videoconferencia. Se utilizó el análisis temático inductivo para identificar los patrones de significados de las parejas participantes. Resultados: Se derivaron cuatro temas fundamentales: (1) confinamiento como estresor (estresores asociados al confinamiento domiciliario y a la pandemia, y asociados a la convivencia forzada); (2) confinamiento como oportunidad (vivir despacio, (re)conexión y fortalecimiento de la pareja, desarrollo de nuevas habilidades, como ayuda en la toma de decisiones y autocuidado); (3) Pareja como apoyo (emocional, cognitivo y conductual); y (4) experiencia post-confinamiento (vuelta a la nueva normalidad y cambios individuales/relacionales percibidos por las parejas). Conclusión: Este estudio aporta evidencias de cómo las relaciones cercanas positivas y de apoyo pueden ser de gran ayuda y actuar como factor protector a la hora de sobrellevar situaciones perniciosas o estresantes como la pandemia COVID-19. Introduction: The COVID-19 pandemic and lockdown have transformed people’s daily lives, modifying social and family relationships, producing alterations that concern their couple lives. Therefore, a challenge has been presented not only for the individual mental health but also for the relational one. Objective: To explore and describe how the lockdown experience has impacted for the couples’ lives, verifying the common and the differential aspects based on gender and to the fact of having children or not. Method: A qualitative methodology was selected, using the focus group for the data collection. A non-probabilistic intentional sampling was used for the selection of the sample, which was composed by 6 couples Andalusians couples. These couples were distributed into 4 groups, according to gender and to the fact of having children or not. The focus group sessions were conducted in videoconference format. Thematic inductive analysis was used to understand patterns of meanings across the focus groups Results: Four fundamental themes were found: (1) lockdown as a stressor (stressors related to lockdown and to the pandemic, and related to forced cohabitation); (2) lockdown as an opportunity (slow living, couple (re)connection and strengthening the relationship, development of new skills, such as help in making decisions and self-care); (3) couple as support (emotional, cognitive and behavioral); and (4) post-lockdown experience (back to the new normality and individual/relational changes perceived by the couples). Conclusion: This study provides evidences on how positive and supportive close relationships could be of great help to couples and act as a protective factor when they cope with so stressful or pernicious situations as the COVID-19 pandemic.
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- 2022
13. Effectiveness of a stepped-care programme of internet-based psychological interventions for healthcare workers with psychological distress: Study protocol for the RESPOND healthcare workers randomised controlled trial
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Mediavilla Torres, Roberto, McGreevy, Kerry R., Felez-Nobrega, Mireia, Monistrol-Mula, Anna, Bravo Ortiz, María Fe, Bayón Pérez, Carmen, Rodríguez Vega, Beatriz, Nicaise, Pablo, Delaire, Audrey, Sijbrandij, Marit, Witteveen, Anke B., Purgato, Marianna, Barbui, Corrado, Tedeschi, Federico, Melchior, Maria, van der Waerden, Judith, McDaid, David, Park, A. La, Kalisch, Raffael, Petri-Romão, Papoula, Underhill, James, Bryant, Richard A., Haro, Josep Maria, Ayuso Mateos, José Luis, RESPOND Consortium, UAM. Departamento de Psiquiatría, Midwifery Science, UCL - SSS/IRSS - Institut de recherche santé et société, Clinical Psychology, APH - Mental Health, and World Health Organization (WHO) Collaborating Center
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BF Psychology ,Medicina ,analysis ,Health Informatics ,psychosocial intervention ,coronavirus disease 2019 ,H Social Sciences ,Health Information Management ,SDG 3 - Good Health and Well-being ,psychological distress ,RA0421 Public health. Hygiene. Preventive Medicine ,COVID-19 ,MeSH terms ,resilience ,anxiety ,workforce and services ,internet-based intervention ,adjustment disorders ,healthcare facilities ,depression ,psychological ,cost ,Health Policy ,Computer Science Applications ,MHSR - Abstract
The dataset that supports the findings of this study are archived in the Universidad Autónoma de Madrid data repository e‐cienciaDatos in https://doi.org/10.21950/HN1HNO, Background and aims: The coronavirus disease 2019 pandemic has challenged health services worldwide, with a worsening of healthcare workers’ mental health within initial pandemic hotspots. In early 2022, the Omicron variant is spreading rapidly around the world. This study explores the effectiveness and cost-effectiveness of a stepped-care programme of scalable, internet-based psychological interventions for distressed health workers on self-reported anxiety and depression symptoms. Methods: We present the study protocol for a multicentre (two sites), parallel-group (1:1 allocation ratio), analyst-blinded, superiority, randomised controlled trial. Healthcare workers with psychological distress will be allocated either to care as usual only or to care as usual plus a stepped-care programme that includes two scalable psychological interventions developed by the World Health Organization: A guided self-help stress management guide (Doing What Matters in Times of Stress) and a five-session cognitive behavioural intervention (Problem Management Plus). All participants will receive a single-session emotional support intervention, namely psychological first aid. We will include 212 participants. An intention-to-treat analysis using linear mixed models will be conducted to explore the programme's effect on anxiety and depression symptoms, as measured by the Patient Health Questionnaire – Anxiety and Depression Scale summary score at 21 weeks from baseline. Secondary outcomes include post-traumatic stress disorder symptoms, resilience, quality of life, cost impact and cost-effectiveness. Conclusions: This study is the first randomised trial that combines two World Health Organization psychological interventions tailored for health workers into one stepped-care programme. Results will inform occupational and mental health prevention, treatment, and recovery strategies. Registration details: ClinicalTrials.gov Identifier: NCT04980326, The RESPOND project was funded under Horizon 2020 -the Framework Programme for Research and Innovation (2014– 2020) (grant number: 101016127), and the work of MF-N was supported by a postdoctoral fellowship of the ISCIII (CD20/ 00036)
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- 2022
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14. WHO Ordinal Scale and Inflammation Risk Categories in COVID-19
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Rubio-Rivas, Manuel, Mora Luján, José María, Formiga Pérez, Francesc, Arévalo-Cañas, Coral, Lebrón Ramos, Juan Manuel, Villalba García, María Victoria, Fonseca Aizpuru, Eva Maria, Díez Manglano, Jesús, Arnalich Fernández, Francisco, Romero Cabrera, Juan Luis, García García, Gema María, Pesqueira Fontan, Paula María, Vargas Núñez, Juan Antonio, Freire Castro, Santiago Jesús, Loureiro Amigo, José, Pascual Pérez, Maria de los Reyes, Alcalá Pedrajas, José Nicolás, Encinas-Sánchez, Daniel, Mella Pérez, Carmen, Ena, Javier, Gracia Gutiérrez, Anyuli, Esteban Giner, María José, Varona, José F., Millán Núñez-Cortés, Jesús, and Casas-Rojo, José Manuel
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Inflammation ,Pronòstic mèdic ,Mortalitat ,COVID-19 ,Mortality ,Prognosis ,Inflamació - Abstract
Background: The WHO ordinal severity scale has been used to predict mortality and guide trials in COVID-19. However, it has its limitations. Objective The present study aims to compare three classificatory and predictive models: the WHO ordinal severity scale, the model based on inflammation grades, and the hybrid model. Design Retrospective cohort study with patient data collected and followed up from March 1, 2020, to May 1, 2021, from the nationwide SEMI-COVID-19 Registry. The primary study outcome was in-hospital mortality. As this was a hospital-based study, the patients included corresponded to categories 3 to 7 of the WHO ordinal scale. Categories 6 and 7 were grouped in the same category. Key Results A total of 17,225 patients were included in the study. Patients classified as high risk in each of the WHO categories according to the degree of inflammation were as follows: 63.8% vs. 79.9% vs. 90.2% vs. 95.1% (p
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- 2022
15. Estrés en tiempos de confinamiento: estrategias de afrontamiento y crecimiento postraumático en población universitaria.
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Hernández-Ballester, Cristina, Ferrer-Pérez, Carmen, Montagud-Romero, Sandra, and del Carmen Blanco-Gandía, María
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- 2023
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16. The Use of Corticosteroids or Tocilizumab in COVID-19 Based on Inflammatory Markers
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Rubio-Rivas, Manuel, Mora-Luján, José M, Montero, Abelardo, Aguilar García, Josefa Andrea, Méndez Bailón, Manuel, Fernández Cruz, Ana, Oriol, Isabel, Teigell-Muñoz, Francisco-Javier, Dendariena Borque, Beatriz, De la Peña Fernández, Andrés, Fernández González, Raquel, Gil Sánchez, Ricardo, Fernández Fernández, Javier, Catalán, Marta, Cortés-Rodríguez, Begoña, Mella Pérez, Carmen, Montero Rivas, Lorena, Suárez Fuentetaja, Rebeca, Ternero Vega, Jara Eloísa, Ena, Javier, Martin-Urda Díez-Canseco, Anabel, Pérez García, Cristina, Varona, José F, Casas-Rojo, José Manuel, Millán Núñez-Cortés, Jesús, and SEMI-COVID-19 Network
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medicine.medical_specialty ,medicine.medical_treatment ,medicine.disease_cause ,Antibodies, Monoclonal, Humanized ,law.invention ,corticosteroids ,chemistry.chemical_compound ,tocilizumab ,Tocilizumab ,law ,Adrenal Cortex Hormones ,Internal medicine ,Lactate dehydrogenase ,Internal Medicine ,medicine ,Humans ,Cause of death ,Original Research ,Retrospective Studies ,Mechanical ventilation ,Inflammation ,treatment ,business.industry ,SARS-CoV-2 ,COVID-19 ,Retrospective cohort study ,Intensive care unit ,mortality ,COVID-19 Drug Treatment ,chemistry ,COVID-19, corticosteroids, mortality, tocilizumab, treatment ,Propensity score matching ,business ,Nasal cannula ,Biomarkers - Abstract
SEMI-COVID-19 Network., [Background] The inflammatory cascade is the main cause of death in COVID-19 patients. Corticosteroids (CS) and tocilizumab (TCZ) are available to treat this escalation but which patients to administer it remains undefined., [Objective] We aimed to evaluate the efficacy of immunosuppressive/anti-inflammatory therapy in COVID-19, based on the degree of inflammation. ., [Design] A retrospective cohort study with data on patients collected and followed up from March 1st, 2020, to May 1st, 2021, from the nationwide Spanish SEMI-COVID-19 Registry. Patients under treatment with CS vs. those under CS plus TCZ were compared. Effectiveness was explored in 3 risk categories (low, intermediate, high) based on lymphocyte count, C-reactive protein (CRP), lactate dehydrogenase (LDH), ferritin, and d-dimer values., [Patients] A total of 21,962 patients were included in the Registry by May 2021. Of these, 5940 met the inclusion criteria for the present study (5332 were treated with CS and 608 with CS plus TCZ)., [Main Measures] The primary outcome of the study was in-hospital mortality. Secondary outcomes were the composite variable of in-hospital mortality, requirement for high-flow nasal cannula (HFNC), non-invasive mechanical ventilation (NIMV), invasive mechanical ventilation (IMV), or intensive care unit (ICU) admission., [Key Results] A total of 5940 met the inclusion criteria for the present study (5332 were treated with CS and 608 with CS plus TCZ). No significant differences were observed in either the low/intermediate-risk category (1.5% vs. 7.4%, p=0.175) or the high-risk category (23.1% vs. 20%, p=0.223) after propensity score matching. A statistically significant lower mortality was observed in the very high–risk category (31.9% vs. 23.9%, p=0.049)., [Conclusions] The prescription of CS alone or in combination with TCZ should be based on the degrees of inflammation and reserve the CS plus TCZ combination for patients at high and especially very high risk.
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- 2021
17. Real-Life Impact of Glucocorticoid Treatment in COVID-19 Mortality: A Multicenter Retrospective Study
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Muñoz-Gómez, Ana, Fernández-Cruz, Ana, Lavilla-Olleros, Cristina, Giner-Galvañ, Vicente, Ausín-García, Cristina, Wikman, Philip, Bendala-Estrada, Alejandro D., Vargas, Juan A., Rubio-Rivas, Manuel, Laureiro, Jaime, Fernández-Bermúdez, Daniel, Buonaiuto, Verónica A., Larriva, Antonio P. Arenas de, Pascual-Pérez, María de los Reyes, Alcalá-Pedrajas, José N., Ruiz, Ane Labirua-Iturburu, Hernández-Milián, Almudena, Mazo, Marta Gómez del, Antequera, Beatriz, Mella-Pérez, Carmen, Navas-Alcántara, María de la Sierra, Soto-Delgado, Juan F., Gámez-Mancera, Rosa M., Sardiña-González, Cristina, Meijide-Míguez, Héctor, Ramos-Rincón, José M., Gómez-Huelgas, Ricardo, Network, on behalf of the SEMI-COVID-19 Network on behalf of the SEMI-COVID-19, [Muñoz-Gómez,A] Internal Medicine Department, Hospital de Parla, Madrid, Spain. [Fernández-Cruz,A] Infectious Diseases Unit, Internal Medicine Department, Hospital Universitario Puerta de Hierro-Majadahonda, Instituto de Investigación Sanitaria Puerta de Hierro—Segovia de Arana, Madrid, Spain. [Lavilla-Olleros,C, Ausín-García,C, Bendala-Estrada,AD] Internal Medicine Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain. [Giner-Galvañ,V, Wikman,P] Internal Medicine Department, Hospital Clínico Universitario de Sant Joan d’Alacant, Fundación para el Fomento de la Investigación Sanitaria y Biomédica en la Comunidad Valenciana (FISABIO), Alicante, Spain. [Vargas,JA] Internal Medicine Department, Hospital Universitario Puerta de Hierro-Majadahonda, Instituto de Investigación Sanitaria Puerta de Hierro—Segovia de Arana, Madrid, Spain. [Rubio-Rivas,M] Department of Internal Medicine, Bellvitge University Hospital, L’Hospitalet de Llobregat, Barcelona, Spain. [Laureiro,J] Doce de Octubre University Hospital, Madrid, Spain. [Fernández-Bermúdez,D] Internal Medicine Department, Costa del Sol Hospital, Marbella, Spain. [Buonaiuto,VA, and Gómez-Huelgas R] Internal Medicine Department, Regional University Hospital of Málaga, Biomedical Research Institute of Málaga (IBIMA), University of Málaga (UMA), Málaga, Spain. [Arenas de Larriva,AP] Lipids and Atherosclerosis Unit, Department of Internal Medicine, Maimonides Biomedical Research Institute of Córdoba (IMIBIC), Reina Sofia University Hospital, University of Córdoba, Córdoba, Spain. [Arenas de Larriva,AP] CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain. [Pascual-Pérez,MLR] Internal Medicine Department, University General Hospital of Elda, Alicante, Spain. [Alcalá-Pedrajas,JN] Internal Medicine Department, Pozoblanco Regional Hospital, Córdoba, Spain. [Labirua-Iturburu Ruiz,A] Santa Marina Hospital, Bilbao, Spain. [Hernández-Milián,A] Internal Medicine Department, Son Llàtzer University Hospital, Palma de Mallorca, Spain. [Gómez Del Mazo,M] Internal Medicine Department, San Pedro Hospital, Logroño, Spain. [Antequera,B] Internal Medicine Department, Sagunto Hospital, Valencia, Spain. [Mella-Pérez,C] Universitary Hospital Complex of Ferrol, A Coruña, Spain. [Navas-Alcántara,MS] Internal Medicine Department, Infanta Margarita Hospital, Cabra, Córdoba, Spain. [Soto-Delgado,JF] Internal Medicine Department, University Hospital of Salamanca, Salamanca, Spain. [Gámez-Mancera,RM] Internal Medicine Department, University Hospital Virgen del Rocío, Sevilla, Spain. [Sardiña-González,C] Internal Medicine Department, Monforte de Lemos Public Hospital, Lugo, Spain. [Meijide-Míguez,H] Internal Medicine Department, Quironsalud Hospital, A Coruña, Spain. [Ramos-Rincón,JM] Department of Clinical Medicine, Miguel Hernandez University of Elche, Alicante, Spain.
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medicine.medical_specialty ,ARDS ,Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Epidemiologic Study Characteristics as Topic::Epidemiologic Studies::Case-Control Studies::Retrospective Studies [Medical Subject Headings] ,medicine.medical_treatment ,Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Statistics as Topic::Confidence Intervals [Medical Subject Headings] ,Article ,Steroid ,corticosteroids ,Estudios retrospectivos ,Diseases::Respiratory Tract Diseases::Respiration Disorders::Respiratory Insufficiency [Medical Subject Headings] ,Internal medicine ,medicine ,Mortalitat ,Mortality ,Glucocorticoides ,Corticoesteroides ,Health Care::Health Care Facilities, Manpower, and Services::Health Facilities::Hospitals [Medical Subject Headings] ,Chemicals and Drugs::Polycyclic Compounds::Steroids [Medical Subject Headings] ,business.industry ,SARS-CoV-2 ,COVID-19 ,Retrospective cohort study ,General Medicine ,medicine.disease ,mortality ,Diseases::Virus Diseases::RNA Virus Infections::Nidovirales Infections::Coronaviridae Infections::Coronavirus Infections [Medical Subject Headings] ,Confidence interval ,Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Statistics as Topic::Probability::Propensity Score [Medical Subject Headings] ,Cortisone ,body regions ,Pneumonia ,Chemicals and Drugs::Hormones, Hormone Substitutes, and Hormone Antagonists::Hormones::Adrenal Cortex Hormones::Glucocorticoids [Medical Subject Headings] ,Respiratory failure ,Cortisona ,Mortalidad ,Propensity score matching ,Diseases::Respiratory Tract Diseases::Respiration Disorders::Respiratory Distress Syndrome, Adult [Medical Subject Headings] ,Medicine ,Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Data Collection::Vital Statistics::Mortality::Hospital Mortality [Medical Subject Headings] ,business ,Glucocorticoid ,medicine.drug - Abstract
We aimed to determine the impact of steroid use in COVID-19 in-hospital mortality, in a retrospective cohort study of the SEMICOVID19 database of admitted patients with SARS-CoV-2 laboratory-confirmed pneumonia from 131 Spanish hospitals. Patients treated with corticosteroids were compared to patients not treated with corticosteroids, and adjusted using a propensity-score for steroid treatment. From March–July 2020, 5.262 (35.26%) were treated with corticosteroids and 9.659 (64.73%) were not. In-hospital mortality overall was 20.50%, it was higher in patients treated with corticosteroids than in controls (28.5% versus 16.2%, OR 2.068 [95% confidence interval, 1.908 to 2.242], p = 0.0001), however, when adjusting by occurrence of ARDS, mortality was significantly lower in the steroid group (43.4% versus 57.6%, OR 0.564 [95% confidence interval, 0.503 to 0.633], p = 0.0001). Moreover, the greater the respiratory failure, the greater the impact on mortality of the steroid treatment. When adjusting these results including the propensity score as a covariate, in-hospital mortality remained significantly lower in the steroid group (OR 0.774 [0.660 to 0.907], p = 0.002). Steroid treatment reduced mortality by 24% relative to no steroid treatment (RRR 0.24). These results support the use of glucocorticoids in COVID-19 in this subgroup of patients.
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- 2021
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18. WHO Ordinal Scale and Inflammation Risk Categories in COVID-19. Comparative Study of the Severity Scales.
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Rubio-Rivas, Manuel, Mora-Luján, José María, Formiga, Francesc, Arévalo-Cañas, Coral, Lebrón Ramos, Juan Manuel, Villalba García, María Victoria, Fonseca Aizpuru, Eva Mª, Díez-Manglano, Jesús, Arnalich Fernández, Francisco, Romero Cabrera, Juan Luis, García García, Gema María, Pesqueira Fontan, Paula M., Vargas Núñez, Juan Antonio, Freire Castro, Santiago Jesús, Loureiro Amigo, José, Pascual Pérez, Maria de los Reyes, Alcalá Pedrajas, José N., Encinas-Sánchez, Daniel, Mella Pérez, Carmen, and Ena, Javier
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Background: The WHO ordinal severity scale has been used to predict mortality and guide trials in COVID-19. However, it has its limitations. Objective: The present study aims to compare three classificatory and predictive models: the WHO ordinal severity scale, the model based on inflammation grades, and the hybrid model. Design: Retrospective cohort study with patient data collected and followed up from March 1, 2020, to May 1, 2021, from the nationwide SEMI-COVID-19 Registry. The primary study outcome was in-hospital mortality. As this was a hospital-based study, the patients included corresponded to categories 3 to 7 of the WHO ordinal scale. Categories 6 and 7 were grouped in the same category. Key Results: A total of 17,225 patients were included in the study. Patients classified as high risk in each of the WHO categories according to the degree of inflammation were as follows: 63.8% vs. 79.9% vs. 90.2% vs. 95.1% (p<0.001). In-hospital mortality for WHO ordinal scale categories 3 to 6/7 was as follows: 0.8% vs. 24.3% vs. 45.3% vs. 34% (p<0.001). In-hospital mortality for the combined categories of ordinal scale 3a to 5b was as follows: 0.4% vs. 1.1% vs. 11.2% vs. 27.5% vs. 35.5% vs. 41.1% (p<0.001). The predictive regression model for in-hospital mortality with our proposed combined ordinal scale reached an AUC=0.871, superior to the two models separately. Conclusions: The present study proposes a new severity grading scale for COVID-19 hospitalized patients. In our opinion, it is the most informative, representative, and predictive scale in COVID-19 patients to date. [ABSTRACT FROM AUTHOR]
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- 2022
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19. Acerca de la calificación del despido que vulnera la pretendida 'prohibición de despedir
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Viqueira Pérez, Carmen, Universidad de Alicante. Departamento de Derecho del Trabajo y de la Seguridad Social, and Derecho del Trabajo y de la Seguridad Social
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Despido ,State of Alarm ,Estado de Alarma ,Unfair ,COVID-19 ,Nulidad ,Dismissal ,Nullity ,Improcedencia ,Derecho del Trabajo y de la Seguridad Social - Abstract
La sentencia aborda la debatida cuestión de la calificación que haya de merecer el despido sin causa acaecido durante el Estado de Alarma y vigente la mediáticamente denominada "prohibición de despedir" contenida en el art. 2 RDL 9/2020, cuyo alcance, como se sabe, es un semillero de cuestiones dudosas que han sido objeto de encontradas interpretaciones. The sentence addresses the debated question of the qualification that the dismissal without cause occurred during the State of Alarm and the media called "prohibition to dismiss" contained in art. 2 RDL 9/2020, which scope, as known, is a hotbed of dubious questions that have been the subject of conflicting interpretations.
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- 2020
20. Colchicine in Recently Hospitalized Patients with COVID-19: A Randomized Controlled Trial (COL-COVID).
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Pascual-Figal, Domingo A, Roura-Piloto, Aychel E, Moral-Escudero, Encarnación, Bernal, Enrique, Albendín-Iglesias, Helena, Pérez-Martínez, M Teresa, Noguera-Velasco, Jose Antonio, Cebreiros-López, Iria, Hernández-Vicente, Álvaro, Vázquez-Andrés, David, Sánchez-Pérez, Carmen, Khan, Amjad, Sánchez-Cabo, Fátima, and García-Vázquez, Elisa
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COVID-19 ,RANDOMIZED controlled trials ,HOSPITAL patients ,COLCHICINE ,COVID-19 treatment - Abstract
Background: Colchicine has been proposed as a potential therapy in coronavirus disease 2019 (COVID-19) due to their anti-inflammatory actions. Methods: The COL-COVID study was a prospective, randomized, controlled and open-label clinical trial that compared colchicine added to standard treatment vs standard treatment in hospitalized COVID-19 patients that do not need mechanical ventilatory support. Colchicine was initiated within the first 48 hours of admission at a 1.5 mg loading dose, followed by 0.5 mg b.i.d. for one week and 0.5 mg per day for 28 days. The study endpoints were clinical status (7-points WHO ordinal scale) and inflammatory biomarkers (IL-6 and CRP). Results: A total of 103 patients (51± 12 years, 52% male) were randomly allocated to colchicine arm (n=52) and control arm (n=51). At day 28, all patients in the colchicine group were alive and discharged, whereas in the control group, two patients died in-hospital and one patient remained hospitalized. Clinical improvement in terms of changes on WHO scale at day 14 and 28 and time to 1-point clinical improvement did not differ between the two groups. Clinical deterioration (increase of at least 1-point in WHO scale) was observed in a higher proportion of cases in colchicine group (13.8%) vs control group (5.8%) (p=0.303); after adjustment by baseline risk factors and concomitant therapies, colchicine therapy was associated with a lower risk of clinical deterioration (p=0.030). Inflammatory biomarkers CRP and IL-6 concentrations course did not differ between the two arms. Conclusion: In hospitalized COVID-19 patients, colchicine treatment neither improved the clinical status, nor the inflammatory response, over the standard treatment. Nevertheless, a preventive effect for further clinical deterioration might be possible. Trial Registration: NCT04350320. [ABSTRACT FROM AUTHOR]
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- 2021
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21. Mortality and other adverse outcomes in patients with type 2 diabetes mellitus admitted for COVID-19 in association with glucose-lowering drugs: a nationwide cohort study.
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Pérez-Belmonte, Luis M., Torres-Peña, José David, López-Carmona, María D., Ayala-Gutiérrez, M. Mar., Fuentes-Jiménez, Francisco, Huerta, Lucía Jorge, Muñoz, Jaime Alonso, Rubio-Rivas, Manuel, Madrazo, Manel, Garcia, Marcos Guzmán, Montes, Beatriz Vicente, Sola, Joaquim Fernández, Ena, Javier, Ferrer, Ruth Gonzalez, Pérez, Carmen Mella, Ripper, Carlos Jorge, Lecumberri, Jose Javier Napal, Acedo, Iris El Attar, Canteli, Susana Plaza, and Cosío, Sara Fuente
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TYPE 2 diabetes ,COVID-19 ,ARTIFICIAL respiration ,PROPENSITY score matching ,INTENSIVE care units - Abstract
Background: Limited evidence exists on the role of glucose-lowering drugs in patients with COVID-19. Our main objective was to examine the association between in-hospital death and each routine at-home glucose-lowering drug both individually and in combination with metformin in patients with type 2 diabetes mellitus admitted for COVID-19. We also evaluated their association with the composite outcome of the need for ICU admission, invasive and non-invasive mechanical ventilation, or in-hospital death as well as on the development of in-hospital complications and a long-time hospital stay.Methods: We selected all patients with type 2 diabetes mellitus in the Spanish Society of Internal Medicine's registry of COVID-19 patients (SEMI-COVID-19 Registry). It is an ongoing, observational, multicenter, nationwide cohort of patients admitted for COVID-19 in Spain from March 1, 2020. Each glucose-lowering drug user was matched with a user of other glucose-lowering drugs in a 1:1 manner by propensity scores. In order to assess the adequacy of propensity score matching, we used the standardized mean difference found in patient characteristics after matching. There was considered to be a significant imbalance in the group if a standardized mean difference > 10% was found. To evaluate the association between treatment and study outcomes, both conditional logit and mixed effect logistic regressions were used when the sample size was ≥ 100.Results: A total of 2666 patients were found in the SEMI-COVID-19 Registry, 1297 on glucose-lowering drugs in monotherapy and 465 in combination with metformin. After propensity matching, 249 patients on metformin, 105 on dipeptidyl peptidase-4 inhibitors, 129 on insulin, 127 on metformin/dipeptidyl peptidase-4 inhibitors, 34 on metformin/sodium-glucose cotransporter 2 inhibitor, and 67 on metformin/insulin were selected. No at-home glucose-lowering drugs showed a significant association with in-hospital death; the composite outcome of the need of intensive care unit admission, mechanical ventilation, or in-hospital death; in-hospital complications; or long-time hospital stays.Conclusions: In patients with type 2 diabetes mellitus admitted for COVID-19, at-home glucose-lowering drugs showed no significant association with mortality and adverse outcomes. Given the close relationship between diabetes and COVID-19 and the limited evidence on the role of glucose-lowering drugs, prospective studies are needed. [ABSTRACT FROM AUTHOR]- Published
- 2020
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22. Validación de una escala de acciones educativas de la familia en confinamiento por COVID-19.
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Pérez-Pérez, Yaima, Teresa Barroso-Pérez, Carmen, José Amaro-Blanco, Armando, and Alexis Lorenzo-Ruiz, C.
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COVID-19 , *TAX administration & procedure , *PSYCHOMETRICS , *PROFESSIONAL practice , *EDUCATIONAL evaluation , *SCHOOL children - Abstract
The quality of an instrument depends on its validity and reliability. Objective: to build and validate a scale for the evaluation of the performance of educational actions of the family with the schoolchild during the confinement by COVID-19. Instrument validation study; 140 families participated. Four components were observed that explained 74.772% of the variance. Reliability by dimensions, Childcare: a = 0.91, Affection: a = 0.850, Communication: a = 0.845, Learning at home: a = 0.919) and Total scale: a = 0.970. The KMO value and the Bartlett sphericity test showed a correlation structure between the variables. The reliability coefficients were high both for dimensions and for the global scale. The results described support that the scale has acceptable psychometric qualities. It provides specific indicators and dimensions to measure what is proposed. Its application is taxed for professional practice and facilitates the description of the performance of educational actions of the family with children at school. [ABSTRACT FROM AUTHOR]
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- 2020
23. Covid 19 and venous thromboembolic disease. Review on a series of patients.
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Jesús Núñez-Fernández, Manuel, Manuel Padín-Paz, Emilio, Suárez-Rodrígue, Beatriz, Pombo - Vide, Beatriz, Mella-Pérez, Carmen, Barbagelata-López, Cristina, Díaz-Peromingo, José Antonio, Puerta-Louro, Rubén, and Rivera-Gallego, Alberto
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COVID-19 ,BLOOD coagulation disorders ,INFLAMMATION ,PULMONARY embolism ,THROMBOPHLEBITIS ,FIBRINOGEN ,FIBRIN fragment D - Published
- 2020
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24. Risk factors and outcome of COVID-19 in patients with hematological malignancies.
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Piñana, José Luis, Martino, Rodrigo, García-García, Irene, Parody, Rocío, Morales, María Dolores, Benzo, Gonzalo, Gómez-Catalan, Irene, Coll, Rosa, De La Fuente, Ignacio, Luna, Alejandro, Merchán, Beatriz, Chinea, Anabelle, de Miguel, Dunia, Serrano, Ana, Pérez, Carmen, Diaz, Carola, Lopez, José Luis, Saez, Adolfo Jesús, Bailen, Rebeca, and Zudaire, Teresa
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HEMATOLOGIC malignancies ,COVID-19 ,STEM cell transplantation ,LOGISTIC regression analysis - Abstract
Background: Prognostic factors of poor outcome in patients with hematological malignancies and COVID-19 are poorly defined. Patients and methods: This was a Spanish transplant group and cell therapy (GETH) multicenter retrospective observational study, which included a large cohort of blood cancer patients with laboratory-confirmed SARS-CoV-2 infection through PCR assays from March 1st 2020 to May 15th 2020. Results: We included 367 pediatric and adult patients with hematological malignancies, including recipients of autologous (ASCT) (n = 58) or allogeneic stem cell transplantation (allo-SCT) (n = 65) from 41 hospitals in Spain. Median age of patients was 64 years (range 1–93.8). Recipients of ASCT and allo-SCT showed lower mortality rates (17% and 18%, respectively) compared to non-SCT patients (31%) (p = 0.02). Prognostic factors identified for day 45 overall mortality (OM) by logistic regression multivariate analysis included age > 70 years [odds ratio (OR) 2.1, 95% confidence interval (CI) 1.2–3.8, p = 0.011]; uncontrolled hematological malignancy (OR 2.9, 95% CI 1.6–5.2, p < 0.0001); ECOG 3–4 (OR, 2.56, 95% CI 1.4–4.7, p = 0.003); neutropenia (< 0.5 × 10
9 /L) (OR 2.8, 95% CI 1.3–6.1, p = 0.01); and a C-reactive protein (CRP) > 20 mg/dL (OR 3.3, 95% CI 1.7–6.4, p < 0.0001). In multivariate analysis of 216 patients with very severe COVID-19, treatment with azithromycin or low dose corticosteroids was associated with lower OM (OR 0.42, 95% CI 0.2–0.89 and OR 0.31, 95% CI 0.11–0.87, respectively, p = 0.02) whereas the use of hidroxycloroquine did not show significant improvement in OM (OR 0.64, 95% CI 0.37–1.1, P = 0.1). Conclusions: In most patients with hematological malignancies COVID-19 mortality was directly driven by older age, disease status, performance status, as well as by immune (neutropenia) parameters and level of inflammation (high CRP). Use of azithromycin and low dose corticosteroids may be of value in very severe COVID-19. [ABSTRACT FROM AUTHOR]- Published
- 2020
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25. Cobertura vacunal en la temporada 2020/2021 ¿Ha sido el síndrome respiratorio agudo severo por coronavirus 2 (SARS - COV - 2) un estímulo para la vacunación?
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Sabina Ríos, Alba, Fernández San Luis, Marta, Marrero Pérez, Carmen Luz, Beatriz Carrero Clemente, González Carretero, Paloma, and Grado En Medicina
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Gripe ,COVID-19 ,Vacunas contra virus influenza - Abstract
Introducción: La irrupción durante 2020 de la pandemia de Enfermedad por Coronavirus 2019 (COVID-19) en España, donde la cobertura vacunal de la gripe en niños con enfermedades de base no supera el 20%, ha conferido una mayor relevancia a la vacunación antigripal. Objetivos: Conocer si se ha modificado la cobertura vacunal frente al virus de la gripe con motivo de la pandemia por coronavirus durante 2020. Analizar el perfil de los nuevos vacunados e identificar los motivos por los que se han vacunado en la temporada actual. Material y métodos: Estudio descriptivo ambispectivo longitudinal en un cupo de pacientes de edades comprendidas entre 6 meses y 14 años, de 952 individuos en 2019 y de 937 en 2020. Se han recogido datos codificados de todos los vacunados contra la gripe desde el comienzo de las campañas de vacunación hasta el 15 de febrero de cada temporada. Posteriormente, se procedió a realizar una encuesta telefónica. Resultados: Se ha encontrado un cambio significativo en las vacunaciones de las dos temporadas con p-valor
- Published
- 2022
26. Indicaciones para la realización de pruebas diagnósticas de infección activa (PDIA) del SARS-CoV-2 en frotis nasofaríngeo en pediatría de atención primaria en otoño e invierno de 2021
- Author
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Vera Estévez, Débora, González Benito, Jonathan, Marrero Pérez, Carmen Luz, Carrero Clemente, Beatriz, and Grado En Medicina
- Subjects
PDIA ,SARS-CoV-2 ,Pediatría ,COVID-19 ,Atención primaria - Abstract
Introducción: La COVID-19 ha supuesto un reto sanitario a nivel mundial. Un sector especialmente afectado fue AP donde se solicitan PDIA diariamente. El principal objetivo de este estudio fue describir los perfiles de pacientes sospechosos de infección y los motivos de indicación más comunes. Material y Métodos: Estudio observacional, descriptivo y transversal en el contexto de una consulta pediátrica en AP. Se evaluaron, por grupos de edad, las características clínicas de los casos sospechosos (165 muestras de pacientes pediátricos), los motivos de consulta más habituales y la positividad ante las PDIA. Resultados: De los 165 casos sospechosos, 12 resultaron positivos en las PDIA. Consultaron por sintomatología sospechosa con 135 casos, 17 fueron contactos asintomáticos y 13 contactos sintomáticos. De los 12 positivos, 6 formaban parte del grupo de asintomáticos y 6 fueron contactos sintomáticos estableciendo una significación estadística entre grupos por motivo de consulta. Además, se observó que el 91,7% de los positivos fueron detectados mediante PCR, mientras que un 8,3% fueron detectados por Test Rápido de Antígenos, existiendo una diferencia estadísticamente significativa entre ambas pruebas. Conclusiones: En la población pediátrica, el perfil clínico del COVID-19 suele ser leve o asintomático y los datos sugieren que no suelen ser los casos índices de la enfermedad. Además, existe una baja positividad ante los Test Rápidos de Antígenos, lo cual puede indicar una baja sensibilidad de estos test para la detección de infección activa en pacientes pediátricos. Introduction: The COVID-19 has meant a sanitary challenge at a global level. A specially affected sector was primary care, where Active Infection Diagnostic Test are requested on a daily basis. The main objective of this study is to describe the profile of patients who are suspicious of infection and the most common reasons for the indication of the Active Infection Diagnostic Test. Material and methods: Observational, descriptive and transversal study in the context of a pediatric consultation in primary care. There were assessed, by age groups, the clinical features of the suspicious cases (165 samples), the most usual consultation reasons and the positivity of the Active Infection Diagnostic Test. Results: From among the 165 suspicious cases, 12 turned out to be positive in the AIDT. 135 consulted because of a suspicious symptomatology, 17 were asymptomatic contacts and 13 symptomatic contacts. From among the 12 positives, 6 were part of the asymptomatic group and 6 were symptomatic contacts, establishing a significant difference between groups due to the consultation reason. Besides, it was observed that the 91,7% of the positives were detected by PCR, whereas a 8,3% was detected by means of a Rapid Antigens Test, existing an statistically significant difference among both tests. Conclusions: In the pediatric population, the COVID-19 clinical profile tends to be mild or asymptomatic and the data suggests that they are not usually the index cases of the disease. Moreover, there is a low positivity when it comes to Rapid Antigens Test, what could show a low sensibility of these tests for the detection of an active infection in pediatric patients.
- Published
- 2022
27. Estudio de impactos de pandemias del siglo XXI en la economía y el sector turístico
- Author
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Fernández Marrero, Fabio and Francisco Pérez, Carmen Gloria
- Subjects
economia ,pandemia ,turismo ,COVID-19 ,soluciones ,impactos - Abstract
El presente trabajo plantea un estudio de los impactos que surgen cuando un desastre como es una pandemia afecta a la economía de un país y en especial al sector turístico. Para ello, se analizan diferentes países que han sufrido este tipo de crisis recogiendo datos de diferentes estudios sobre los efectos en la economía y el turismo, así como las soluciones y medidas que se tomaron en su momento para minimizar esos daños. Además, se analizan y comparan las pandemias anteriores con la situación actual mostrando los efectos que está provocando el SARS-CoV-2 en el mundo. Asimismo, se recogen los impactos del COVID-19 en España junto con las soluciones que está imponiendo el gobierno para que el sector turístico se recupere. Por último, se proponen ciertas medidas que se deberían implantar para una recuperación turística rápida y robusta. This work presents a study of the impacts that arise when a disaster such as a pandemic affects the economy of a country and especially the tourism sector. For this, different countries that have suffered this type of crisis are analyzed, collecting data from different studies on the effects on the economy and tourism as well as the solutions and measures that were taken at the time to minimize these damages. Furthermore, previous pandemics are analyzed and compared with the current situation, showing the effects that SARS-CoV-2 is causing in the world. Likewise, the impacts of COVID-19 in Spain are included together with the solutions that the government is imposing so that the tourist sector recovers. Finally, certain measures are proposed that should be implemented for a rapid and robust tourist recovery.
- Published
- 2020
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