Yacobitti A, Otero L, Doldan Arrubarrena V, Arano J, Lage S, Silberman M, Zubieta M, Erbetta I, Danei P, Baeck G, Vallejos V, Cavalli F, Calderón N, Di Gregorio M, Hernandez V, Bruno D, Rodera B, Macherett I, Parisi M, Gallastegui M, Paz A, Bernardi R, Azcárate S, Hraste A, Caridi I, Boechi L, Salgado P, Kochen S
Network Patient Management, Hospital El Cruce N Kirchner, F. Varela, Pcia Buenos Aires, Argentina.
Planning Area, Hospital El Cruce N Kirchner, F. Varela, Pcia Buenos Aires, Argentina.
Sci Rep. 2021 May 6;11(1):9679. doi: 10.1038/s41598-021-87552-w.
There is not in Argentina publications regarding the presentation of patients with COVID-19 requiring hospitalized and emergency care in vulnerable populations (lower incomes and less education tend at greater risk for poor health status and healthcare access), and it has few reports in developing countries. The objective is to determine whether in the care of vulnerable patients, to succeed against COVID-19, multiple public health tools and interventions will be needed to minimize morbidity and mortality. The study is a prospective cohort investigation of patients with lab-confirmed COVID-19, who required to any of the Health Centers response from April 8, 2020, to August 18, 2020. In Buenos Aires Metropolitan Area (AMBA), April 8, 2020 the virus was identified in patients hospitalized in the "Southeast Network" (SN), AMBA. SN covering an area of 661 square kilometers, with 1.8 million inhabitants residing in urban, and rural areas. A total of 14 health centers with different levels of care complexity provide care to patients in the region. The information of each patient with COVID-19 evaluated by SN, was incorporated in an Epidemiological Dashboard. The investigation was designed and reported with consideration of observational studies in epidemiology. We describe the hospitals presentation and care of persons who required SN response and were ultimately diagnosed with COVID-19. From April 8, 2020, to August 18, 2020, were included 1495 patients with lab-confirmed COVID-19 in SN. A total of 58% patients were men, and the mean age (SD) was 48.9 (15.59) years. Eighty one percent patients with pre-existing diseases, most frequent hypertension and diabetes, but hypertension, chronic lung disease, and cardiovascular disease presented higher risk. A total of 13% were hospitalized in Intensive Therapy Unit. The mortality of the cohort was 9.77%. Mortality was higher for patients aged 65 or more (OR 5.09), and for those had some pre-existing disease (OR 2.61). Our observations are consistent with reports demonstrating older persons, and those with comorbidities have the highest risk of mortality related to COVID-19. However, unlike other reports from developed or some developing countries, the mortality in our study is lower. This finding may be related to age of our cohort is younger than other published. Also, the health system was able to respond to the demand.
在阿根廷，尚无关于新冠病毒疾病患者（需要住院治疗和急诊护理的弱势群体，低收入和低教育程度人群往往健康状况较差且医疗服务可及性较低）情况的相关出版物，并且在发展中国家此类报告也很少。本研究的目的是确定在对弱势群体的护理中，为成功抗击新冠病毒疾病，是否需要多种公共卫生工具和干预措施来尽量降低发病率和死亡率。该研究是一项对实验室确诊的新冠病毒疾病患者的前瞻性队列调查，这些患者在2020年4月8日至2020年8月18日期间需要任何健康中心的响应。在布宜诺斯艾利斯大都市区（AMBA），2020年4月8日在“东南网络”（SN）、AMBA住院的患者中发现了该病毒。SN覆盖面积661平方公里，有180万居民居住在城市和农村地区。共有14个护理复杂程度不同的健康中心为该地区的患者提供护理。由SN评估的每位新冠病毒疾病患者的信息被纳入一个流行病学信息平台。该调查的设计和报告考虑了流行病学中的观察性研究。我们描述了那些需要SN响应并最终被诊断为新冠病毒疾病的患者的医院情况和护理情况。从2020年4月8日至2020年8月18日，SN共纳入1495例实验室确诊的新冠病毒疾病患者。共有58%的患者为男性，平均年龄（标准差）为48.9（15.59）岁。81%的患者有既往疾病，最常见的是高血压和糖尿病，但高血压、慢性肺病和心血管疾病患者的风险更高。共有13%的患者入住重症监护病房。该队列的死亡率为9.77%（95%置信区间：7.85%，11.89%）。65岁及以上患者的死亡率更高（比值比5.09），以及那些有一些既往疾病的患者死亡率更高（比值比2.61）。我们的观察结果与其他报告一致，这些报告表明老年人以及患有合并症的人死于新冠病毒疾病的风险最高。然而，与来自发达国家或一些发展中国家的其他报告不同，我们研究中的死亡率较低。这一发现可能与我们队列的年龄比其他已发表研究中的年龄更年轻有关。此外，卫生系统能够应对需求。
