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      Seguimiento de los pacientes con cardiopatía isquémica en un centro de atención primaria durante la pandemia por COVID-19 Translated title: Coronary heart disease follow-up in a Primary Health Care centre during the COVID-19 pandemic

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          Abstract

          RESUMEN Objetivo: describir el seguimiento de los factores de riesgo cardiovascular modificables (FRCM) de los pacientes con cardiopatía isquémica (CI) en un centro de salud durante el primer año la pandemia por COVID-19. Material y métodos: estudio observacional ambispectivo de un centro de salud de Madrid. Participantes: pacientes diagnosticados de CI antes de 2020, > 45 años (n: 257). Seguimiento: del 13/03/2020 al 13/03/2021. Variables: sociodemográficas, comorbilidades, análisis de sangre (AS), colesterol asociado a lipoproteínas de baja densidad (c-LDL), exploración física (tensión arterial [TA] e índice de masa corporal [IMC]), eventos cardiovasculares (ECV) y fallecimiento en el seguimiento. Se realizó en tres períodos: situación basal: registro previo al inicio de la pandemia; primer período: del 13/03/2020 al 13/09/2020; segundo período: del 14/09/2020 al 13/03/2021. Datos obtenidos de la historia clínica electrónica. Análisis: STATA16. Resultados: se hizo el seguimiento de 257 pacientes (edad: 73,14 ± 0,7; 67,3% hombres) diagnosticados de CI hace 7 años (rango intercuartílico [RIC]: 4-14). AS (al 65,6% de los pacientes se les hizo análisis en el primer período versus al 20,6% en el segundo período del estudio), TA (57,5% versus 18,6%) e IMC (29,5% versus 7,7%). Mejoraron el c-LDL hasta 2,2 mg/dL, y el IMC, 0,6 kg/m2. Empeoró la TA sistólica hasta 6,3 mmHg y la diastólica 2,5 mmHg. Un 7,7% sufrió un ECV en el primer período y un 5,8% en el segundo. Fallecieron 9 pacientes durante el seguimiento. Conclusión: casi dos tercios de los pacientes con CI habían realizado seguimiento de LDL y TA en los 6 primeros meses tras el inicio de la pandemia. El número de seguimientos caía a 1/3 al año. El IMC fue la variable menos evaluada.

          Translated abstract

          ABSTRACT Aim: to report the follow up of modifiable cardiovascular risk factors (CVRF) of patients with ischaemic heart disease in a health centre during the first year of the COVID-19 pandemic. Materials and Methods: observational follow-up study of an ambispective cohort in a Madrid health centre. Subjects: patients with CHD prior to 2020, > 45 years (n:257). Follow up: from 13/03/2020 to 13/03/2021. Variables: sociodemographic, comorbidities, blood test (BT) (LDL-c), physical examination, (blood pressure [BP] and BMI), cardiovascular events (CVE), and death during follow up. Performed over three periods: baseline period: data before the pandemic commenced. First period: 13/03/2020-13/09/2020. Second period: 14/09/2020-13/03/2021. Data collection: electronic medical record. Analysis: STATA16. Results: a total of 257 patients with CHD was followed up (age: 73.14±0.7; 67.3% male). CHD diagnosis seven years ago (IQR:4-14). BT in 65.6% of patients in the first time period vs 20.6% in the second time period, BP 57.5% vs 18.6% and BMI 29.5% vs 7.7%. LDL-c and BMI improved during follow up to 2.2 mg/dL and 0.6 kg/m2, respectively. Systolic and diastolic BP worsened up to 6.3 mmHg and 2.5 mmHg, respectively. A total of 7.7% and 5.8% suffered a CVE in the first and second time periods, respectively. In all nine patients died during follow up. Conclusion: virtually two thirds of patients with CHD had undertaken LDL-c and BP follow up in the six months since the COVID-19 pandemic started. This number decreased to one third over the year. BMI was the least evaluated variable.

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          Prevalence of SARS-CoV-2 in Spain (ENE-COVID): a nationwide, population-based seroepidemiological study

          Summary Background Spain is one of the European countries most affected by the COVID-19 pandemic. Serological surveys are a valuable tool to assess the extent of the epidemic, given the existence of asymptomatic cases and little access to diagnostic tests. This nationwide population-based study aims to estimate the seroprevalence of SARS-CoV-2 infection in Spain at national and regional level. Methods 35 883 households were selected from municipal rolls using two-stage random sampling stratified by province and municipality size, with all residents invited to participate. From April 27 to May 11, 2020, 61 075 participants (75·1% of all contacted individuals within selected households) answered a questionnaire on history of symptoms compatible with COVID-19 and risk factors, received a point-of-care antibody test, and, if agreed, donated a blood sample for additional testing with a chemiluminescent microparticle immunoassay. Prevalences of IgG antibodies were adjusted using sampling weights and post-stratification to allow for differences in non-response rates based on age group, sex, and census-tract income. Using results for both tests, we calculated a seroprevalence range maximising either specificity (positive for both tests) or sensitivity (positive for either test). Findings Seroprevalence was 5·0% (95% CI 4·7–5·4) by the point-of-care test and 4·6% (4·3–5·0) by immunoassay, with a specificity–sensitivity range of 3·7% (3·3–4·0; both tests positive) to 6·2% (5·8–6·6; either test positive), with no differences by sex and lower seroprevalence in children younger than 10 years ( 10%) and lower in coastal areas (<3%). Seroprevalence among 195 participants with positive PCR more than 14 days before the study visit ranged from 87·6% (81·1–92·1; both tests positive) to 91·8% (86·3–95·3; either test positive). In 7273 individuals with anosmia or at least three symptoms, seroprevalence ranged from 15·3% (13·8–16·8) to 19·3% (17·7–21·0). Around a third of seropositive participants were asymptomatic, ranging from 21·9% (19·1–24·9) to 35·8% (33·1–38·5). Only 19·5% (16·3–23·2) of symptomatic participants who were seropositive by both the point-of-care test and immunoassay reported a previous PCR test. Interpretation The majority of the Spanish population is seronegative to SARS-CoV-2 infection, even in hotspot areas. Most PCR-confirmed cases have detectable antibodies, but a substantial proportion of people with symptoms compatible with COVID-19 did not have a PCR test and at least a third of infections determined by serology were asymptomatic. These results emphasise the need for maintaining public health measures to avoid a new epidemic wave. Funding Spanish Ministry of Health, Institute of Health Carlos III, and Spanish National Health System.
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            2016 ESC Guidelines for the Diagnosis and Treatment of Acute and Chronic Heart Failure.

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              Adherence to cardiovascular therapy: a meta-analysis of prevalence and clinical consequences.

              The aim of this study was to determine the extent to which adherence to individual vascular medications, assessed by different methods, influences the absolute and relative risks (RRs) of cardiovascular disease (CVD) and all-cause mortality.
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                Author and article information

                Journal
                albacete
                Revista Clínica de Medicina de Familia
                Rev Clin Med Fam
                Sociedad Española de Medicina de Familia y Comunitaria (Barcelona, Cataluña, Spain )
                1699-695X
                2386-8201
                2023
                : 16
                : 1
                : 11-16
                Affiliations
                [2] Madrid orgnameComunidad de Madrid orgdiv1Área Norte orgdiv2Unidad Docente Multiprofesional de Atención Familiar y Comunitaria España
                [1] Madrid orgnameCentro de Salud Federica Montseny España
                Article
                S1699-695X2023000100003 S1699-695X(23)01600100003
                10.55783/rcmf.160103
                a07ec26f-3fcf-40e3-8bf6-7d731880d093

                This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

                History
                : 19 September 2022
                : 17 January 2023
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 25, Pages: 6
                Product

                SciELO Spain

                Categories
                Originales

                SARS-CoV-2,COVID-19,Myocardial Ischaemia,Subsequent Care,isquemia miocárdica,factores de riesgo de enfermedad cardíaca,cuidados posteriores,Cardiovascular Risk Factors

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