[Factors associated with an unfavorable evolution in patients diagnosed with COVID-19 and followed up in primary care in 2020].

Autor:	Fernández Pérez MJ; Medicina de Familia y Comunitaria, Centro de Salud de Casas Ibáñez, Albacete, España., Bernad Carbonell F; Medicina de Familia y Comunitaria, Centro de Salud Zona IV de Albacete, Albacete, España., Nieves Sanchis MÁ; Medicina de Familia y Comunitaria, Centro de Salud Zona IV de Albacete, Albacete, España., Calleja Argudo S; Medicina de Familia y Comunitaria, Centro de Salud Zona IV de Albacete, Albacete, España., Martínez González A; Medicina de Familia y Comunitaria, Centro de Salud Zona IV de Albacete, Albacete, España., García de Enterría Ramos I; Medicina de Familia y Comunitaria, Servicio de Urgencias del Hospital General de Albacete, Albacete, España., Ayuso Raya MC; Medicina de Familia y Comunitaria, Servicio de Urgencias del Hospital General de Albacete, Albacete, España., Escobar Rabadán F; Medicina de Familia y Comunitaria, Centro de Salud Zona IV de Albacete, Albacete, España. Electronic address: fjescobarr@sescam.jccm.es.
Jazyk:	Spanish; Castilian
Zdroj:	Atencion primaria [Aten Primaria] 2022 Sep; Vol. 54 (9), pp. 102372. Date of Electronic Publication: 2022 Apr 29.
DOI:	10.1016/j.aprim.2022.102372
Abstrakt:	Aim: To know the factors associated with an unfavorable evolution (UE) of patients diagnosed with COVID-19 with total or partial follow-up in primary care. Design: A case series. Setting: Urban health center. Participants: By systematic sampling, patients ≥18 years, diagnosed with COVID-19, with analytical confirmation, in 2020 and followed up by their family doctors, were selected. Main Measurements: Dependent variable: hospital admission or death due to COVID-19. Independent Variables: age, sex, medical background, clinical data and treatments related to the disease. Statistical analysis, with SPSS 25.0: descriptive analysis, comparison of proportions (chi square) and medians (Mann-Whitney U). The analysis is completed with logistic regression. Results: 610 patients were included in the study. The median age was 49 years (interquartile range: 35-61); 51.8% were women; 14.9% presented UE (95% CI: 12.0-17.8). The sociodemographic variables or the variables related to medical background that showed an independent association with UE were age (OR: 1.066; 95% CI: 1.038-1.095), sex (OR for men: 3.277; 95% CI: 1.304-8.235) and being a smoker or former smoker (OR: 2.565; 95% CI: 1.135-5.800). Regarding the clinical variables of the disease, an association was found for altered consciousness (OR: 62.829; 95% CI: 9.177-430.149), dyspnea (OR: 14.339; 95% CI: 6.046-34.009), expectoration (OR: 4.764; 95% CI: 1.858-12.213)) and asthenia (OR: 3.993; 95% CI: 1.705-9.351). Conclusions: 14.9% of the patients diagnosed with COVID-19 presented an UE. Older age, male sex and being a smoker or former smoker increased the probability of it. Altered consciousness, dyspnea, expectoration, and asthenia were the clinical data that best predicted UE. (Copyright © 2022 The Author(s). Publicado por Elsevier España, S.L.U. All rights reserved.)
Databáze:	MEDLINE
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