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一组从初级卫生保健机构进行随访的COVID-19感染疑似病例的演变情况。

Evolution of a Cohort of COVID-19 Infection Suspects Followed-Up from Primary Health Care.

作者信息

Coronado-Vázquez Valle, Ramírez-Durán Maria Del Valle, Gómez-Salgado Juan, Dorado-Rabaneda María Silvia, Benito-Alonso Elena, Holgado-Juan Marina, Bronchalo-González Cristina

机构信息

Group B21-20R, Health Research Institute of Aragon (IIS), 50009 Zaragoza, Spain.

Centro de Salud de Illescas, Servicio de Salud de Castilla-La Mancha, 45200 Toledo, Spain.

出版信息

J Pers Med. 2021 May 24;11(6):459. doi: 10.3390/jpm11060459.

Abstract

Diagnosis and home follow-up of patients affected by COVID-19 is being approached by primary health care professionals through telephone consultations. This modality of teleconsultation allows one to follow the evolution of patients and attend early to possible complications of the disease. The purpose of the study was to analyze the evolution of a cohort of patients with suspected SARS-CoV-2 disease followed by primary care professionals and to determine the factors that are associated with hospital admission. A prospective cohort study was carried out on 166 patients selected by consecutive sampling that showed symptoms compatible with COVID-19. The follow-up was approached via telephone for 14 days analyzing hospitalization and comorbidities of the patients. There were 75% of the hospitalized patients that were male ( = 0.002), and 70.8% presented comorbidities ( < 0.001). In patients with diabetes, the risk of hospitalization was 4.6-times larger, in hypertension patients it was 3.3-times, those suffering from renal insufficiency 3.8-times, and immunosuppressed patients 4.8-times (IC 95%: 1.9-11.7). In 86.7% of the cases, clinical deterioration was diagnosed in the first seven days of the infection, and 72% of healing was reached from day seven to fourteen. Monitoring from primary care of patients with COVID-19 allows early diagnosis of clinical deterioration and detection of comorbidities associated with the risk of poor evolution and hospital admission.

摘要

基层医疗保健专业人员通过电话咨询对感染新冠病毒的患者进行诊断和家庭随访。这种远程咨询方式能够跟踪患者的病情发展,并尽早处理该疾病可能出现的并发症。本研究的目的是分析一组疑似感染新冠病毒且由基层医疗保健专业人员随访的患者的病情发展情况,并确定与住院相关的因素。对166例通过连续抽样选取的、表现出与新冠病毒疾病相符症状的患者进行了一项前瞻性队列研究。通过电话对患者进行了为期14天的随访,分析患者的住院情况和合并症。75%的住院患者为男性(P = 0.002),70.8%的患者患有合并症(P < 0.001)。糖尿病患者的住院风险高出4.6倍,高血压患者高出3.3倍,肾功能不全患者高出3.8倍,免疫抑制患者高出4.8倍(95%置信区间:1.9 - 11.7)。在86.7%的病例中,在感染的前七天诊断出临床病情恶化,从第七天到第十四天有72%的患者病情好转。对新冠病毒疾病患者进行基层医疗监测有助于早期诊断临床病情恶化,并检测出与病情发展不良和住院风险相关的合并症。

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