Condición postCOVID-19 en trabajadores de la salud. La Habana. Un año de seguimiento <span class="so-article-trans-title" dir="auto"> Translated title: PostCOVID-19 condition in health workers. Havana: one-year follow-up </span>

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Abstract

RESUMEN Introducción: La COVID-19 es una enfermedad con brechas en su conocimiento. Se requiere explorar sus manifestaciones clínicas en el tiempo y consecuencias para el desempeño en la población trabajadora. Objetivo: Identificar características clínica-epidemiológicas y aptitud para el trabajo en trabajadores de la salud convalecientes de la COVID-19. Material y Métodos: Se realizó un estudio longitudinal prospectivo con trabajadores de la salud de La Habana. La población estuvo constituida por 40 trabajadores, quienes acudieron a consulta de convalecientes de la COVID-19 en mayo de 2021, a los que se les dio seguimiento hasta mayo de 2022. Resultados: Persistieron al cierre del año, la disnea (18,8 %), insomnio (18,8 %), artralgia (12,5 %). La hipertensión arterial, obesidad y asma bronquial fueron las principales comorbilidades. Aptos para el puesto trabajo, 100 % de los trabajadores. Conclusiones: Los síntomas postCOVID-19 disminuyeron considerablemente a partir de los 8 meses del inicio de la enfermedad y persistieron la disnea, artralgia e insomnio al cierre del año.

Translated abstract

ABSTRACT Introduction: COVID-19 is a disease with gaps in its knowledge. It is required to explore its clinical manifestations over time and consequences for performance in the working population. Objective: To identify the clinico-epidemiological characteristics and the fitness to work in health workers convalescing from COVID-19. Material and Methods: A prospective longitudinal study was carried out on health workers in Havana. The population consisted of 40 workers who attended the COVID-19 convalescent consultation and were followed up in May 2022. Results: Dyspnea (18.8 %), insomnia (18.8 %), and arthralgia (12.5 %) persisted at the end of the year. Hypertension, obesity and bronchial asthma were the main comorbidities. In addition, 100 % of workers were fit for work. Conclusions: PostCOVID-19 symptoms deceased considerably 8 months after the onset of the disease; dyspnea, arthralgia, and insomnia persisted at the end of the year.

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6-month consequences of COVID-19 in patients discharged from hospital: a cohort study

Chaolin Huang, Lixue Huang, Yeming Wang … (2021)

Background The long-term health consequences of COVID-19 remain largely unclear. The aim of this study was to describe the long-term health consequences of patients with COVID-19 who have been discharged from hospital and investigate the associated risk factors, in particular disease severity. Methods We did an ambidirectional cohort study of patients with confirmed COVID-19 who had been discharged from Jin Yin-tan Hospital (Wuhan, China) between Jan 7, 2020, and May 29, 2020. Patients who died before follow-up, patients for whom follow-up would be difficult because of psychotic disorders, dementia, or re-admission to hospital, those who were unable to move freely due to concomitant osteoarthropathy or immobile before or after discharge due to diseases such as stroke or pulmonary embolism, those who declined to participate, those who could not be contacted, and those living outside of Wuhan or in nursing or welfare homes were all excluded. All patients were interviewed with a series of questionnaires for evaluation of symptoms and health-related quality of life, underwent physical examinations and a 6-min walking test, and received blood tests. A stratified sampling procedure was used to sample patients according to their highest seven-category scale during their hospital stay as 3, 4, and 5–6, to receive pulmonary function test, high resolution CT of the chest, and ultrasonography. Enrolled patients who had participated in the Lopinavir Trial for Suppression of SARS-CoV-2 in China received severe acute respiratory syndrome coronavirus 2 antibody tests. Multivariable adjusted linear or logistic regression models were used to evaluate the association between disease severity and long-term health consequences. Findings In total, 1733 of 2469 discharged patients with COVID-19 were enrolled after 736 were excluded. Patients had a median age of 57·0 (IQR 47·0–65·0) years and 897 (52%) were men. The follow-up study was done from June 16, to Sept 3, 2020, and the median follow-up time after symptom onset was 186·0 (175·0–199·0) days. Fatigue or muscle weakness (63%, 1038 of 1655) and sleep difficulties (26%, 437 of 1655) were the most common symptoms. Anxiety or depression was reported among 23% (367 of 1617) of patients. The proportions of median 6-min walking distance less than the lower limit of the normal range were 24% for those at severity scale 3, 22% for severity scale 4, and 29% for severity scale 5–6. The corresponding proportions of patients with diffusion impairment were 22% for severity scale 3, 29% for scale 4, and 56% for scale 5–6, and median CT scores were 3·0 (IQR 2·0–5·0) for severity scale 3, 4·0 (3·0–5·0) for scale 4, and 5·0 (4·0–6·0) for scale 5–6. After multivariable adjustment, patients showed an odds ratio (OR) 1·61 (95% CI 0·80–3·25) for scale 4 versus scale 3 and 4·60 (1·85–11·48) for scale 5–6 versus scale 3 for diffusion impairment; OR 0·88 (0·66–1·17) for scale 4 versus scale 3 and OR 1·77 (1·05–2·97) for scale 5–6 versus scale 3 for anxiety or depression, and OR 0·74 (0·58–0·96) for scale 4 versus scale 3 and 2·69 (1·46–4·96) for scale 5–6 versus scale 3 for fatigue or muscle weakness. Of 94 patients with blood antibodies tested at follow-up, the seropositivity (96·2% vs 58·5%) and median titres (19·0 vs 10·0) of the neutralising antibodies were significantly lower compared with at the acute phase. 107 of 822 participants without acute kidney injury and with estimated glomerular filtration rate (eGFR) 90 mL/min per 1·73 m2 or more at acute phase had eGFR less than 90 mL/min per 1·73 m2 at follow-up. Interpretation At 6 months after acute infection, COVID-19 survivors were mainly troubled with fatigue or muscle weakness, sleep difficulties, and anxiety or depression. Patients who were more severely ill during their hospital stay had more severe impaired pulmonary diffusion capacities and abnormal chest imaging manifestations, and are the main target population for intervention of long-term recovery. Funding National Natural Science Foundation of China, Chinese Academy of Medical Sciences Innovation Fund for Medical Sciences, National Key Research and Development Program of China, Major Projects of National Science and Technology on New Drug Creation and Development of Pulmonary Tuberculosis, and Peking Union Medical College Foundation.

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Risk factors of critical & mortal COVID-19 cases: A systematic literature review and meta-analysis

Zhaohai Zheng, Fang Fang Peng, Buyun Xu … (2020)

Background An epidemic of Coronavirus Disease 2019 (COVID-19) began in December 2019 and triggered a Public Health Emergency of International Concern (PHEIC). We aimed to find risk factors for the progression of COVID-19 to help reducing the risk of critical illness and death for clinical help. Methods The data of COVID-19 patients until March 20, 2020 were retrieved from four databases. We statistically analyzed the risk factors of critical/mortal and non-critical COVID-19 patients with meta-analysis. Results Thirteen studies were included in Meta-analysis, including a total number of 3027 patients with SARS-CoV-2 infection. Male, older than 65, and smoking were risk factors for disease progression in patients with COVID-19 (male: OR = 1.76, 95% CI (1.41, 2.18), P 40U/L, creatinine(Cr) ≥ 133mol/L, hypersensitive cardiac troponin I(hs-cTnI) > 28pg/mL, procalcitonin(PCT) > 0.5ng/mL, lactatede hydrogenase(LDH) > 245U/L, and D-dimer > 0.5mg/L predicted the deterioration of disease while white blood cells(WBC) 40U/L:OR=4.00, 95% CI (2.46, 6.52), P 28 pg/mL: OR = 43.24, 95% CI (9.92, 188.49), P 0.5 ng/mL: OR = 43.24, 95% CI (9.92, 188.49), P 245U/L: OR = 43.24, 95% CI (9.92, 188.49), P 0.5mg/L: OR = 43.24, 95% CI (9.92, 188.49), P < 0.00001; WBC < 4 × 109/L: OR = 0.30, 95% CI (0.17, 0.51), P < 0.00001]. Conclusion Male, aged over 65, smoking patients might face a greater risk of developing into the critical or mortal condition and the comorbidities such as hypertension, diabetes, cardiovascular disease, and respiratory diseases could also greatly affect the prognosis of the COVID-19. Clinical manifestation such as fever, shortness of breath or dyspnea and laboratory examination such as WBC, AST, Cr, PCT, LDH, hs-cTnI and D-dimer could imply the progression of COVID-19.

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Olfactory and gustatory dysfunctions as a clinical presentation of mild-to-moderate forms of the coronavirus disease (COVID-19): a multicenter European study

Jerome R. Lechien, Carlos M Chiesa-Estomba, Daniele De Siati … (2020)

Objective To investigate the occurrence of olfactory and gustatory dysfunctions in patients with laboratory-confirmed COVID-19 infection. Methods Patients with laboratory-confirmed COVID-19 infection were recruited from 12 European hospitals. The following epidemiological and clinical outcomes have been studied: age, sex, ethnicity, comorbidities, and general and otolaryngological symptoms. Patients completed olfactory and gustatory questionnaires based on the smell and taste component of the National Health and Nutrition Examination Survey, and the short version of the Questionnaire of Olfactory Disorders-Negative Statements (sQOD-NS). Results A total of 417 mild-to-moderate COVID-19 patients completed the study (263 females). The most prevalent general symptoms consisted of cough, myalgia, and loss of appetite. Face pain and nasal obstruction were the most disease-related otolaryngological symptoms. 85.6% and 88.0% of patients reported olfactory and gustatory dysfunctions, respectively. There was a significant association between both disorders (p < 0.001). Olfactory dysfunction (OD) appeared before the other symptoms in 11.8% of cases. The sQO-NS scores were significantly lower in patients with anosmia compared with normosmic or hyposmic individuals (p = 0.001). Among the 18.2% of patients without nasal obstruction or rhinorrhea, 79.7% were hyposmic or anosmic. The early olfactory recovery rate was 44.0%. Females were significantly more affected by olfactory and gustatory dysfunctions than males (p = 0.001). Conclusion Olfactory and gustatory disorders are prevalent symptoms in European COVID-19 patients, who may not have nasal symptoms. The sudden anosmia or ageusia need to be recognized by the international scientific community as important symptoms of the COVID-19 infection. Electronic supplementary material The online version of this article (10.1007/s00405-020-05965-1) contains supplementary material, which is available to authorized users.

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Author and article information

Journal

Journal ID (publisher-id): rhcm

Title: Revista Habanera de Ciencias Médicas

Abbreviated Title: Rev haban cienc méd

Publisher: Universidad de Ciencias Médicas de la Habana (La Habana, , Cuba )

ISSN (Electronic): 1729-519X

Publication date (Print and electronic): December 2022

Volume: 21

Issue: 6

Electronic Location Identifier: e5034

Affiliations

[2] La Habana orgnameUniversidad de Ciencias Médicas de La Habana Cuba

[1] La Habana orgnameInstituto Nacional de Salud de los Trabajadores Cuba

Article

Publisher ID: S1729-519X2022000600009 Publisher ID: S1729-519X(22)02100600009

SO-VID: f881049d-8f35-4ea8-80d3-95bff2099b49

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

History

Date received : 05 October 2022

Date accepted : 07 December 2022

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Figures: 0, Tables: 0, Equations: 0, References: 23, Pages: 0

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Cited by 1

Condición postCOVID-19. Perfil clínico-epidemiológico en trabajadores de diferentes sectores ocupacionales de La Habana
Authors: Sandra Santana López, Arlene Oramas Viera

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Most referenced authors 689

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Condición postCOVID-19 en trabajadores de la salud. La Habana. Un año de seguimiento Translated title: PostCOVID-19 condition in health workers. Havana: one-year follow-up

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