Estudio descriptivo de infección por SARS-CoV-2 en adultos con diabetes
Descriptive study of infection by SARS-CoV-2 in adults with diabetes

Murujosa, Ana Clara; Hospital Italiano de Buenos Aires. Servicio de Clínica Médica. AR, Pasik, Natalia I.; Hospital Italiano de Buenos Aires. Servicio de Clínica Médica. AR, Leer más

Giuliani Quaglierini, Sofía A.; Hospital Italiano de Buenos Aires. Instituto Universitario Hospital Italiano. AR, Risso, María Aime; Hospital Italiano de Buenos Aires. Instituto Universitario Hospital Italiano. AR, Burgos, Mariana A.; Hospital Italiano de Buenos Aires. Área de Investigación en Medicina Interna. AR, Grande Ratti, María Florencia; Hospital Italiano de Buenos Aires. Área de Investigación en Medicina Interna. AR, Russo, María Paula; Hospital Italiano de Buenos Aires. Servicio de Clínica Médica. AR

Fuente científica: Medicina (B.Aires)

Fecha de actualización: 6 Abril, 2022

Resumen El objetivo del trabajo fue estimar la prevalencia de diabetes mellitus (DM) entre los pacientes con COVID-19, explorar factores asociados y describir la evolución clínica de aquellos hospitalizados. Se realizó un estudio de corte transversal que incluyó adultos positivos para COVID-19 entre 12/03/2020 y 15/10/2020, en el Hospital Italiano de Buenos Aires. De un total de 6009 personas con COVID-19, 408 presentaron diagnóstico previo de DM, arrojando una prevalencia de 6% (IC95% 6-7%), con mayor prevalencia asociada a la edad (12% en ≥ 60 años y 3% en < 60 años; p = 0.01). La mortalidad intrahospitalaria fue 6% (IC95% 6-7), siendo 15% en DM y 6% en no diabéticos (p < 0.01). Los factores asociados a la DM fueron variables, cardiovasculares, sexo masculino, hipertensión arterial, tabaquismo, insuficiencia renal crónica, insuficiencia cardíaca, enfermedad coronaria previa; y variables clínicas de fragilidad como edad, demencia e institucionalización previa (todas con p < 0.01). Solo el 23% (96/408) de los DM tuvo una medición de HbA1c en los últimos 3 meses y el 76% en el último año, con un promedio 8.6%, y un 25% en meta (HbA1c ≥ 7%). El manejo fue mayoritariamente intrahospitalario (59%), con un promedio de estadía hospitalaria de 12 días, con las siguientes complicaciones durante la hospitalización: 6% presentó un valor de hipoglucemia (< 70 mg/dl), 42% requirió oxigenoterapia, el 19% pasó a unidad cerrada, 15% requirió ARM (media de 11 días), y 25% (IC95% 20-31%) de mortalidad (promedio de 82 años).

Abstract The main objective was to estimate the prevalence of diabetes mellitus (DM) among patients with COVID-19, to explore associ ated factors; and to describe clinical evolution of hospitalized patients. A cross-sectional study was conducted, which included adults confirmed with COVID-19 between 03/12/2020 and 10/15/2020, at Hospital Italiano de Buenos Aires. From 6009 people with COVID-19, 408 had previous diagnosis of DM, yielding a prevalence of 6% (95%CI 6-7), higher prevalence was associated with age (12% in ≥ 60 years and 3% in < 60 years; p = 0.01). In-hospital mortality was 6% (95%CI 6-7), being 15% in DM and 6% compared in non-diabetics (p < 0.01). As sociated factors with DM were cardiovascular variables such as male sex, hypertension, smoking, chronic renal failure, heart failure, previous coronary disease; and clinical variables proxy of frailty such as: age, dementia and previous institutionalization (all with p < 0.01). Only 23% (96/408) of DM had an HbA1c measurement in the last 3 months and 76% in the last year, with an average 8.6%, and 25% in goal (HbA1c ≤ 7%). Management was mostly in-hospital (59%), with an average hospital stay of 12 days, with the following complications during hospitalization: 6% presented a hypoglycemic value (< 70 mg/dl), 42% required oxygen therapy, 19 % went to intensive care unit, 15% required invasive mechanical ventilation (mean 11 days), and 25% (95%CI 20-31) of in-hospital mortality (mean 82 years).

Palabras clave: COVID-19, COVID-19, Diabetes mellitus, Diabetes mellitus, Hospital mortality, Mortalidad hospitalaria

Capacidad estructural, recursos humanos tecnológicos y requerimientos de ventilación mecánica en 58 unidades de cuidados intensivos en argentina durante la pandemia por SARS-CoV-2. Estudio SATICOVID-19
Structural capacity, technological human resources and mechanical ventilation requirements in 58 intensive care units in Argentina during the SARS-CoV-2 pandemic. A SATICOVID-19 Study

Estenssoro, Elisa; Hospital Interzonal de Agudos General San Martín. , Plotnikow, Gustavo; Sanatorio Las Lomas. , Leer más

Loudet, Cecilia I.; Hospital Interzonal de Agudos General San Martín. , Ríos, Fernando G.; Hospital Juan A. Fernández. , Kanoore Edul, Vanina S.; Hospital Juan A. Fernández. , Andrian, Macarena; Hospital Provincial Dr. Castro Rendón. , Romero, Ignacio; Sanatorio Güemes. , Sagardía, Judith; Hospital Alejandro Posadas. , Bezzi, Marco; Hospital Santojanni. , Mandich, Verónica; Hospital Santojanni. UTICOVID-19. , Groer, Carla; Hospital Juan A. Fernández. , Torres, Sebastián; Sanatorio Anchorena San Martín. , Orlandi, Cristina; Hospital Francisco López Lima. , Birri, Paolo Nahuel; Sanatorio Otamendi. , Rubatto Valenti, María Florencia; Sanatorio de Los Arcos. , Cunto, Eleonora; Hospital Dr. Francisco J. Muñiz. , Sáenz, María Gabriela; Hospital Interzonal de Agudos General San Martín. , Tiribelli, Norberto; Complejo Médico de la Policía Federal Argentina Churruca Visca. , Aphalo, Vanina; Sanatorio Las Lomas. , Betttini, Lisandro; Hospital Provincial del Centenario. , Reina, Rosa; Sociedad Argentina de Terapia Intensiva. AR, Dubin, Arnaldo; Sanatorio Otamendi.

Fuente científica: Medicina (B.Aires)

Fecha de actualización: 6 Abril, 2022

Resumen Durante la pandemia por SARS-CoV-2 hubo un marcado requerimiento de camas de cuidados críticos, insumos y profesionales entrenados para asistir a pacientes con insuficiencia respiratoria grave. La Sociedad Argentina de Terapia Intensiva (SATI) diseñó un estudio para caracterizar estos aspectos en las Unidades de Cuidados Intensivos (UCIs). Estudio multicéntrico, de cohorte prospectiva; las UCIs participantes completaron un formulario al final del estudio (31/10/2020) sobre características hospitalarias, número de camas de áreas críticas pre- e intra-pandemia, incorporación de profesionales, insumos y recursos tecnológicos, y carga de trabajo. Participaron 58 UCIs; 28(48%) de Provincia de Buenos Aires, 22(38%) de Ciudad Autónoma de Bue nos Aires, 10(17%) de otras; 31(53%) UCIs pertenecían al sector público; 23(47%) al privado-seguridad social. En 35/58(60%) hospitales las camas de cuidados críticos aumentaron de 902 a 1575(75%); 37% en UCI y 63% principalmente en Unidad Coronaria y Emergencias-shock room. En 41/55(75%) UCIs se incorporó personal: 27(49%) médicos/as (70% intensivistas), 36(65%) enfermeros/as, 28(51%) kinesiólogos/as, 20(36%) personal de limpieza, y 1(2%) otros/as; 96% de las UCIS reportaron disponer de respiradores suficientes, y 95%, insumos y EPP suficientes. De todos los pacientes en ventilación mecánica invasiva, 55% [43-64] presentaron COVID-19. Se requirió oxigenoterapia como soporte no invasivo en 14% [8-24] de los ingresos por COVID-19. Se registró una importante expansión de las áreas críticas operativas, secundariamente al aumento de camas, personal, y adecuada disponibilidad de respiradores e insumos esenciales. La carga de la enfermedad crítica por COVID-19 fue intensa, constituyendo más de la mitad de los pacientes en ventilación mecánica.

Abstract During the SARS-CoV-2 pandemic, there was a marked requirement for critical care beds, supplies and trained professionals to assist patients with severe respiratory failure. The Argentine Society of Intensive Care (SATI) designed a study to characterize these aspects in intensive care units (ICUs). Multicenter, prospective cohort study; the participating ICUs completed a form at the end of the study (31/10/2020) on hospital characteristics, number of beds in pre- and intra-pandemic critical areas, incorporation of professionals, technological resources, and workload. Fifty-eight ICUs participated; 28(48%) were located in Buenos Aires Province, 22(38%) in Buenos Aires Autonomous City and 10 (17%) in other provinces; 31 (53%) of UCIs belonged to the public sector; 23 (47%) to the private-social security. In 35/58 (60%) of the hospitals critical care beds increased from 902 to 1575 (75%), 37% in ICU and 63% mainly in Coronary Care Unit and Emergency-shock room. In 41/55 (75%) UCIs, staff were incorporated: 27(49%) physicians (70% intensivists), 36 (65%) nurses, 28 (51%) respiratory therapists, 20(36%) cleaning staff, and 1(2%) others. A 96% of the ICUS reported having sufficient ventilators and 95% enough sup plies and PPE. Of all patients on invasive mechanical ventilation, 55% [43-64] had COVID-19. Oxygen therapy was required as noninvasive support in 14% [8-24] of COVID-19 admissions. There was a significant expansion of critical operational areas, secondary to the increase in beds, staff, and adequate availability of ventilators and essential supplies. The burden of critical illness from COVID-19 was intense, with more than half of patients on mechanical ventilation.

Palabras clave: Administración de salud, COVID-19, COVID-19, Capacidad suplementaria hospitalaria, Coronavirus, Hospital preparedness, ICU, Insuficiencia respiratoria, Pandemia, Respiratory failure, Surge capacity

Terapia nasal de alto flujo en insuficiencia respiratoria grave por SARS-CoV-2
High-flow nasal therapy in severe respiratory failure due to SARS-CoV-2

Molini, Walter J.; Hospital Provincial Neuquén Dr. Eduardo Castro Rendón. Servicio Clínica Médica. AR, Gonzalez, Rocío M.; Hospital Provincial Neuquén Dr. Eduardo Castro Rendón. Servicio Clínica Médica. AR, Leer más

Villalba, Leonardo M.; Hospital Provincial Neuquén Dr. Eduardo Castro Rendón. Servicio Clínica Médica. AR, Ruiz, Ernesto F.; Hospital Provincial Neuquén Dr. Eduardo Castro Rendón. Servicio Clínica Médica. AR, Diocares, Luciano A.; Hospital Provincial Neuquén Dr. Eduardo Castro Rendón. Servicio Clínica Médica. AR, Anticura, Daniela B.; Hospital Zapala Dr. Jorge Juan Pose. Servicio Clínica Médica. AR, Martínez, Fernando E.; Hospital Zapala Dr. Jorge Juan Pose. Servicio Clínica Médica. AR, Castro, César H.; Hospital Chos Malal Dr. Gregorio Álvarez. Servicio Clínica Médica. AR, Salvador, Soledad M.; Hospital Chos Malal Dr. Gregorio Álvarez. Servicio Clínica Médica. AR

Fuente científica: Medicina (B.Aires)

Fecha de actualización: 6 Abril, 2022

Resumen El uso de terapia nasal de alto flujo (TNAFO) en pacientes con insuficiencia respiratoria aguda grave (IRAG) por neumonía COVID-19 (NCOVID-19) es debatido. Ante la falta de camas en Unidades de Cuidados Intensivos en el Sistema de Salud Pública de la Provincia del Neuquén, se implementó su uso en salas generales. Con el objetivo de describir la experiencia de uso de la TNAFO en pacientes con IRAG por NCOVID-19, se llevó a cabo este estudio retrospectivo multicéntrico. El resultado primario fue la frecuencia de destete exitoso de TNAFO y la mortalidad intrahospitalaria (MIH). Se analizaron 299 pacientes, de éstos, 120 (40.1%) fueron retirados con éxito de la TNAFO. Esta fracasó en 59.8% (179), 44.1% (132) requirió ventilación mecánica invasiva (VMI) y 15.7% (47) no eran candidatos a la intubación. Un índice ROX ≥ 5 a las 6 h después del inicio, se asoció con el éxito de la TNAFO (OR 0.26 [IC 95% 0.15-0.46] p<0.0001). La MIH general fue del 48.5% (145/299), 70.4% (93/132) en aquellos con VMI, 4.2% (5/120) falleció post destete exitoso de la TNAFO y 100% (47/47) en el grupo no candidatos a la intubación. Los pacientes con TNAFO tuvieron una disminución estadísticamente significativa en la MIH y en días de internación. El uso de TNAFO en salas generales logró una reducción en la utilización de VMI, con una reducción de la mortalidad y días de estada en los internados por NCOVID-19 con IRAG.

Abstract The use of high-flow nasal therapy (HFNT) in patients with severe acute respiratory failure (SARF) due to COVID-19 pneu monia (NCOVID-19) is debated. Given the lack of beds in Intensive Care Units in the Public Health System of the Province of Neuquén, their use was implemented in general wards. This restrospective multicenter study was carried out to describe the experience of using HNFT in patients with SARF due to NCOVID-19. The primary outcome was the frequency of successful weaning from HFNT and in-hospital mortality (IHM). Two hundred ninety-nine patients were analyzed; 120 (40.1%) were successfully withdrawn from HFNT. This failed in 59.8% (179), 44.1% (132) required invasive mechanical ventilation (IMV), and 15.7% (47) was not candidates for intubation. A ROX index ≥ 5 at 6 h after initiation was associated with the success of HFNT (OR 0.26 [IC 95% 0.15-0.46] p<0.0001). The general IHM was 48.5% (145/299), 70.4% (93/132) in patients with IMV, 4.2% (5/120) died after successful weaning from HFNT and 100% (47/47) in the group not candidates for intubation. Patients with TNAFO had a statistically significant decrease in MIH and days of hospitalization. TNAFO in general wards achieved a decrease in the use of IMV, with a reduction in mortality and days of stay in hospitalized for NCOVID-19 with SARF.

Palabras clave: COVID-19, COVID-19, High-flow nasal therapy, Insuficiencia respiratoria aguda grave, Invasive mechanical ventilation, Severe acute respiratory failure, Terapia nasal de alto flujo, Ventilación mecánica invasiva

Hallazgos ecocardiográficos en pacientes bajo ventilación mecánica con síndrome de dificultad respiratoria aguda por COVID-19
Echocardiographic findings in patients under mechanical ventilation with COVID-19 acute respiratory distress syndrome

López Saubidet, Ignacio; Hospital Universitario CEMIC. Servicio de Terapia Intensiva. AR, Hunter, Martín; Hospital Universitario CEMIC. Servicio de Terapia Intensiva. AR, Leer más

Lurbet, María Fernanda; Hospital Universitario CEMIC. Servicio de Terapia Intensiva. AR, Bonelli, Ignacio; Hospital Universitario CEMIC. Servicio de Terapia Intensiva. AR, Mandó, Florencia; Hospital Universitario CEMIC. Servicio de Cardiología. AR, Parodi, Josefina; Hospital Universitario CEMIC. Servicio de Cardiología. AR, Torres, Víctor; Hospital Universitario CEMIC. Servicio de Cardiología. AR, Spernanzoni, Fernando; Hospital Universitario CEMIC. Servicio de Cardiología. AR, Rodríguez, Pablo O,; Hospital Universitario CEMIC. Servicio de Terapia Intensiva. AR

Fuente científica: Medicina (B.Aires)

Fecha de actualización: 6 Abril, 2022

Resumen La enfermedad por coronavirus 2019 (COVID-19) produce una carga significativa para los pacientes gravemente enfermos afectados por insuficiencia respiratoria aguda. El objetivo de este estudio fue describir los hallazgos ecocardiográficos en una serie de pacientes ventilados mecánicamente con síndrome de dificultad respiratoria aguda (SDRA) moderado y grave debido a COVID-19. Se trata de un estudio unicéntrico, descriptivo y de corte transversal de datos recopilados en forma prospectiva. Los pacientes tenían una infección por el coronavirus SARS-Cov-2 y SDRA moderado o grave. El ecocardiogra ma inicial se realizó dentro de los 7 días del ingreso en la unidad de cuidados intensivos y luego cada 15 días hasta finalizar la ventilación mecánica, 28 días o fallecimiento. Se midió el tiempo empleado por el operador en cada estudio. Se adquirieron múltiples medidas ecográficas. Se analizaron 33 pacientes. El número total de ecocardiogramas realizados fue de 76. El tiempo necesario (mediana [RIQ]) para la obtención de las imágenes de un estudio estándar fue de 13 [10-15] minutos. Las anomalías estructurales crónicas estuvieron presentes en 16 pacientes (48%), siendo la hipertrofia ventricular izquierda la principal (11 pacientes, 33%). El hallazgo agudo o dinámico más frecuente fue el agrandamiento del ventrículo derecho (VD) (43%) al considerar todos los ecocardiogramas realizados desde el ingreso hasta el día 28 de seguimiento. Otros hallazgos fueron: hipertensión pulmonar (15%), anomalías del movimiento de la pared regional del VI nuevas o dinámicas (15%), deterioro de la contractilidad global del ventrículo izquierdo, nuevo o dinámico (6%), e hipercontractilidad (12%).

Abstract Coronavirus disease 2019 (COVID-19) produces a significant burden to severely ill patients affected by acute respiratory failure. The aim of this study was to describe echocardiographic findings in a series of mechanically ventilated patients with moderate and severe acute respiratory distress syndrome (ARDS) due to COVID-19. This was a single center, descriptive and cros s-sectional study of prospectively collected data. Patients had severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and moderate or severe ARDS. Initial echocardiogram was performed within 7 days of intensive care unit admission and every 15 days until mechanical ventilation ended, 28 days or death. Time spent by the physician for each study was measured. Multiple echographic measurements were acquired; 33 patients were analyzed. Total number of echocardiograms performed was 76. The median imaging time required to complete a standard study was 13 [10-15] minutes. Chronic structural abnormalities were present in 16 patients (48%), being LV hypertrophy the main finding in 11 patients (33%). The most frequent acute or dynamic finding was RV enlargement (43%) when considering all echocardiograms performed from admission to day 28 of follow-up. Other findings were: pulmonary hypertension (15%), new or dynamic left ventricle (LV) regional wall motion abnormalities (15%), new or dynamic LV global contractility deterioration (6%) and hypercontractility (12%).

Palabras clave: Acute respiratory distress syndrome right ventricle, COVID-19, COVID-19, Echocardiography, Ecocardiograma, Síndrome de dificultad respiratoria aguda, Ventrículo derecho

Condiciones del aprendizaje en las residencias del equipo de salud durante la pandemia COVID-19, Argentina 2020
Learning conditions in health team residences during the COVID-19 pandemic, Argentina 2020

Hernández, Cecilia I.; Hospital Italiano de Buenos Aires. Instituto Universitario. Centro de Investigación en Educación de Profesionales de la Salud. , Eymann, Alfredo; Hospital Italiano de Buenos Aires. Instituto Universitario. Centro de Investigación en Educación de Profesionales de la Salud. , Leer más

Ladenheim, Roberta I.; Hospital Italiano de Buenos Aires. Instituto Universitario. Centro de Investigación en Educación de Profesionales de la Salud. , Duré, María Isabel; Universidad Nacional del Sur. Centro de Estudios en Educación de Profesionales de la Salud. AR, García Dieguez, Marcelo; Universidad Nacional del Sur. Centro de Estudios en Educación de Profesionales de la Salud. AR

Fuente científica: Medicina (B.Aires)

Fecha de actualización: 6 Abril, 2022

Resumen La pandemia COVID-19 afectó las condiciones de aprendizaje en las residencias del equipo de salud. El objetivo fue explorar las percepciones de residentes de Argentina sobre las condiciones generales de su formación en este contexto. Se realizó un estudio descriptivo, cuali-cuantitativo, a través de un cuestionario en línea, anónimo, con 17 ítems de opciones cerradas y 25 con escala de Likert de 1 a 5, con un muestreo no probabilístico e intencional. Respondieron 1595 residentes, 74% médicos, 47.1% pertenecía a una especialidad clínica y 21.8% a la primera línea de atención. El 77.2% se desempeñó en residencias públicas y el 89.4% en el ámbito hospitalario. El 42.1% asumió tareas no propias de su especialidad. Hubo acuerdo sobre la disponibilidad de insumos y protección personal (media 3.8 ± 1.3), la afectación de clases y conferencias (media 3.5 ± 1.6), procedimientos (media 3.8 ± 1.4) y rotaciones (media 3.7 ± 1.2). Asimismo, sobre prorrogar la formación para recuperar aprendizajes (media 3 ± 1.6). La disminución de prácticas se asoció a especialidades quirúrgicas (p = 0.0001) y no estar en la primera línea de atención (p = 0.007). Percibieron positivamente el fortalecimiento de vínculos entre residentes y con familiares, y negativos los efectos en la salud por estrés y distanciamiento social. En conclusión, las condiciones generales de la formación se vieron afectadas. Esto conduce a pensar tanto en la necesidad de alternativas curriculares de enseñanza y evaluación, como en intervenciones vinculadas al bienestar de los residentes.

Abstract COVID-19 pandemic modified learning conditions in health professions´ residences. The objective of the research was to explore Argentinian residents´ perceptions regarding training conditions during the first year of pandemic. A descriptive, quali-quantitative study was developed through an online, anonymous questionnaire, with 42 items: 17 closed options and 25 Likert scale from 1 to 5; and 2 open questions. Sampling was intentional and non-probabilistic. The questionnaire was answered by 1595 residents, 74% were physicians, 47.1% belonged to clinical specialties and 21.8% worked on the front line of care. A 77.2% worked in the public sector and 89.4% in hospital practice, 42.1% assumed tasks not typical of their specialty. They agreed on the availability of personal protection and supplies (mean 3.8 ± 1.3), reduction of lectures (mean 3.5 ± 1.6), proce dures (mean 3.8 ± 1.4) and rotations (mean 3.7 ± 1.2). They concurred on the need to extend training to recover learning (mean 3 ± 1.6). The decrease in practices was associated with surgical specialties (p = 0.0001) and not practicing in the front line of care (p = 0.007). They perceived as positive aspects the chance to strengthen bonds between residents and closeness with relatives, and negative aspects the effects on health due to stress and social distancing. In conclusion, the general conditions of training were affected. This leads to rethink the teaching and assessment curricular alternatives, as well as interventions related to the well-being of the residents.

Palabras clave: Aprendizaje, Bienestar, Equipo de salud, Health team, Learning, Pandemia, Pandemic, Well-being

Secondary bacterial infections in patients with coronavirus disease 2019-associated pneumonia

Aydemir, Ozlem; Sakarya University. Faculty of Medicine. Department of Medical Microbiology. Sakarya. TR, Aydemir, Yusuf; Sakarya University. Faculty of Medicine. Department of Pulmonology. Sakarya. TR, Leer más

Şahin, Elif Özözen; Sakarya University. Faculty of Medicine. Department of Medical Microbiology. Sakarya. TR, Şahin, Fatih; Sakarya University. Faculty of Medicine. Department of Anesthesiology and Reanimation. Sakarya. TR, Koroglu, Mehmet; Sakarya University. Faculty of Medicine. Department of Medical Microbiology. Sakarya. TR, Erdem, Ali Fuat; Sakarya University. Faculty of Medicine. Department of Anesthesiology and Reanimation. Sakarya. TR

Fuente científica: Rev. Assoc. Med. Bras. (1992)

Fecha de actualización: 6 Abril, 2022

SUMMARY OBJECTIVE: The vast majority of patients who hospitalized with coronavirus disease 2019 are given empirical antibiotic therapy. However, information on the frequency, microorganism species, and resistance rates of secondary bacterial infections in coronavirus disease 2019 patients are insufficient. We aimed to show the frequency of secondary infections and resistance conditions in patients with coronavirus disease 2019 hospitalized in the intensive care unit. METHODS: The results of tracheal aspirate culture, blood culture, and urine culture obtained from coronavirus disease 2019 patients - at least 2 days after their admission to the intensive care unit - were examined microbiologically. RESULTS: A total of 514 patients hospitalized in intensive care unit were included in our study. Tracheal aspirate, blood, or urine cultures were collected from 369 patients (71.8%). Bacterial reproduction was detected in at least one sample in 171 (33.3%) of all patients. The rate of respiratory tract infection and/or bloodstream infection was found to be 21%. Acinetobacter baumannii, Klebsiella pneumoniae, and Pseudomonas aeruginosa in tracheal aspirate culture; Coagulase-negative staphylococci, K. pneumoniae, and A. baumannii in blood culture; and Escherichia coli, K. pneumoniae, and Enterococcus faecalis in urine culture were the most common microorganisms. A. baumannii was resistant to most antibiotics except colistin and P. aeruginosa strains were resistant to most antibiotics except amikacin, colistin, cefepime, and imipenem. In K. pneumoniae, the highest meropenem sensitivity (73%) was observed; there was a strong resistance to most of the remaining antibiotics. CONCLUSIONS: We think that our study can be useful in choosing empirical antibiotic therapy in the coronavirus disease 2019 pandemic and reducing the mortality that may occur with secondary infection.

Palabras clave: Antimicrobial Susceptibility, COVID-19, Nasocomial infections, Secondary infection

Impacto da Primeira Onda da Pandemia de COVID-19 na Cirurgia Cardiovascular no Brasil: Análise de um Centro Terciário de Referência
Impact of the First Wave of the COVID-19 Pandemic on Cardiovascular Surgery in Brazil: Analysis of a Tertiary Reference Center

Lisboa, Luiz Augusto; Universidade de São Paulo. Faculdade de Medicina. Instituto do Coração. São Paulo. BR, Mejia, Omar Asdrúbal Vilca; Universidade de São Paulo. Faculdade de Medicina. Instituto do Coração. São Paulo. BR, Leer más

Arita, Elisandra Trevisan; Universidade de São Paulo. Faculdade de Medicina. Instituto do Coração. São Paulo. BR, Guerreiro, Gustavo Pampolha; Universidade de São Paulo. Faculdade de Medicina. Instituto do Coração. São Paulo. BR, Silveira, Lucas Molinari Veloso da; Universidade de São Paulo. Faculdade de Medicina. Instituto do Coração. São Paulo. BR, Brandão, Carlos Manuel de Almeida; Universidade de São Paulo. Faculdade de Medicina. Instituto do Coração. São Paulo. BR, Dias, Ricardo Ribeiro; Universidade de São Paulo. Faculdade de Medicina. Instituto do Coração. São Paulo. BR, Dallan, Luís Roberto Palma; Universidade de São Paulo. Faculdade de Medicina. Instituto do Coração. São Paulo. BR, Miana, Leonardo; Universidade de São Paulo. Faculdade de Medicina. Instituto do Coração. São Paulo. BR, Caneo, Luiz F; Universidade de São Paulo. Faculdade de Medicina. Instituto do Coração. São Paulo. BR, Jatene, Marcelo Biscegli; Universidade de São Paulo. Faculdade de Medicina. Instituto do Coração. São Paulo. BR, Dallan, Luís Alberto Oliveira; Universidade de São Paulo. Faculdade de Medicina. Instituto do Coração. São Paulo. BR, Jatene, Fabio Biscegli; Universidade de São Paulo. Faculdade de Medicina. Instituto do Coração. São Paulo. BR

Fuente científica: Arq. bras. cardiol

Fecha de actualización: 6 Abril, 2022

Palabras clave: Atenção Terciária à Saúde, COVID-19, COVID-19, Cardiopatias Congênitas/cirurgia, Cirurgia Torácica, Elective Surgical Procedures, Heart Defects Congenital /surgery, Hospitalization, Hospitalização, Mortalidade, Mortality, Pandemia, Pandemics, Procedimentos Cirúrgicos Eletivos, Tertiary Healthcare/trends, Thoracic Surgery

Predictors of mortality in patients less than 50 years old with coronavirus disease 2019: a multicenter experience in Istanbul

Güven, Ramazan; University of Health Sciences. Kanuni Sultan Suleeyman Training and Research Hospital. Department of Emergency Medicine. Istanbul. TR, Çolak, Şahin; University of Health Sciences. Haydarpasa Numune Training and Research Hospital. Department of Emergency Medicine. Istanbul. TR, Leer más

Sogut, Ozgur; University of Health Sciences. Haseki Training and Research Hospital. Department of Emergency Medicine. Istanbul. TR, Yavuz, Burcu Genc; University of Health Sciences. Haydarpasa Numune Training and Research Hospital. Department of Emergency Medicine. Istanbul. TR, Çalık, Mustafa; University of Health Sciences. Gaziosmanpasa Training and Research Hospital. Department of Emergency Medicine. Istanbul. TR, Altınbilek, Ertuğrul; University of Health Sciences. Sisli Etfal Training and Research Hospital. Department of Emergency Medicine. Istanbul. TR, Hokenek, Nihat Mujdat; University of Health Sciences. Kartal Dr. Lutfi Kirdar Training and Research Hospital. Department of Emergency Medicine. Istanbul. TR, Eyüpoğlu, Gökhan; University of Health Sciences. Basaksehir Cam and Sakura City Hospital. Department of Emergency Medicine. Istanbul. TR, Tayfur, Ismail; University of Health Sciences. Sancaktepe Sehit Prof. Dr. Ilhan Varank Training and Research Hospital. Department of Emergency Medicine. Istanbul. TR, Çakir, Adem; University of Health Sciences. Basaksehir Cam and Sakura City Hospital. Department of Emergency Medicine. Istanbul. TR

Fuente científica: Rev. Assoc. Med. Bras. (1992)

Fecha de actualización: 6 Abril, 2022

SUMMARY OBJECTIVE: The objectives of this study were to identify predictors of mortality in young adult patients with coronavirus disease 2019 and to assess the link between blood type and mortality in those patients. METHODS: This multicenter retrospective study, which was conducted in seven training and research hospitals in Istanbul, involved young adults who aged ≥18 and <50 years and hospitalized with coronavirus disease 2019. RESULTS: Among 1,120 patients, confusion at admission (p<0.001) and oxygen saturation (p<0.001) were significantly predictive factors of mortality. Blood type O was significantly associated with mortality compared to those discharged from the hospital (p<0.001). Among co-morbidities, the most reliable predictive factors were cerebral vascular disease (p<0.001) and chronic renal failure (p=0.010). Among laboratory parameters, high C-reactive protein (p<0.001) and low albumin (p<0.001) levels were predictors of mortality in young adult patients with coronavirus disease 2019. CONCLUSIONS: SpO2 at admission was the best predictor of mortality in young adult patients with coronavirus disease 2019. The mortality rate was increased by cerebral vascular disease and chronic renal failure. Also, high C-reactive protein and low albumin levels were predictive factors of mortality. Moreover, blood type O was associated with a higher mortality rate than the other types.

Palabras clave: Adult, COVID-19, Mortality

Respiratory muscle sequelae in young university students infected by coronavirus disease 2019: an observational study

Plaza, Marta de la; Universidad Europea da Madrid. Faculty of Sports Sciences. Department of Physiotherapy. Madrid. ES, Sevilla, Guillermo García Pérez de; Universidad Europea da Madrid. Faculty of Sports Sciences. Department of Physiotherapy. Madrid. ES


Fuente científica: Rev. Assoc. Med. Bras. (1992)

Fecha de actualización: 6 Abril, 2022

SUMMARY BACKGROUND: The infection caused by coronavirus disease 2019 can lead to respiratory sequelae in individuals who have experienced severe or mild symptoms. METHODS: An observational, cross-sectional study was developed, following the STROBE guidelines. Maximal inspiratory and expiratory mouth pressures were assessed in 50 healthy young students (26 women, 24 men; age 22.20±2.41 years). The inclusion criteria were as follows: aged between 18 and 35 years; control group: not diagnosed with coronavirus disease 2019; and coronavirus disease 2019 group: diagnosed with coronavirus disease 2019, at least 6 months ago. The exclusion criteria were as follows: obese/overweight; infected with coronavirus disease 2019 or coronavirus disease 2019 symptoms in the last 6 months; smokers; and asthmatics. RESULTS: When comparing with groups, the coronavirus disease 2019 group presented statistically significant lower maximal inspiratory pressure values compared with the control group (88.32±16.62 vs. 101.01±17.42 cm H2O; p=0.01). Regarding the maximal expiratory pressure, no significant differences were found. Similar results were found when performing a subgroup analysis by sex and group. CONCLUSIONS: Young students who suffered from coronavirus disease 2019 asymptomatically or mildly at least 6 months ago presented a significant decrease in the inspiratory muscle strength as a sequel, so we believe that patients affected by this disease should have a brief postinfection assessment of this musculature to detect the indication for cardiorespiratory rehabilitation.

Palabras clave: COVID-19, Complications, Respiratory muscle, SARS-CoV-2, Students