Background Long-term effects of COVID-19, also called Long COVID, affect more than 10% of patients. The most severe cases (i.e. those requiring hospitalization) present a higher frequency of sequelae, but detailed information on these effects is still lacking. The objective of this study is to identify and quantify the frequency and outcomes associated with the presence of sequelae or persistent symptomatology (SPS) during the 6 months after discharge for COVID-19. Methods Retrospective observational 6-month follow-up study conducted in four hospitals of Spain. A cohort of all 969 patients who were hospitalized with PCR-confirmed SARS-CoV-2 from March 1 to April 15, 2020, was included. We collected all the SPS during the 6 months after discharge reported by patients during follow-up from primary care records. Cluster analyses were performed to validate the measures. The main outcome measures were return to the Emergency Services, hospital readmission and post-discharge death. Surviving patients’ outcomes were collected through clinical histories and primary care reports. Multiple logistic regression models were applied. Results The 797 (82.2%) patients who survived constituted the sample followed, while the rest died from COVID-19. The mean age was 63.0 years, 53.7% of them were men and 509 (63.9%) reported some sequelae during the first 6 months after discharge. These sequelae were very diverse, but the most frequent were respiratory (42.0%), systemic (36.1%), neurological (20.8%), mental health (12.2%) and infectious (7.9%) SPS, with some differences by sex. Women presented higher frequencies of headache and mental health SPS, among others. A total of 160 (20.1%) patients returned to the Emergency Services, 35 (4.4%) required hospital readmission and 8 (1.0%) died during follow-up. The main factors independently associated with the return to Emergency Services were persistent fever, dermatological SPS, arrythmia or palpitations, thoracic pain and pneumonia. Conclusions COVID-19 cases requiring hospitalization during the first wave of the pandemic developed a significant range of mid- to long-term SPS. A detailed list of symptoms and outcomes is provided in this multicentre study. Identification of possible factors associated with these SPS could be useful to optimize preventive follow-up strategies in primary care for the coming months of the pandemic.

The aim of this paper is to make a descriptive analysis of Problematic Internet Use in college students, evaluating the possible association with health problems and addictive behaviors, as well as gender differences in user types. A total of 2,780 students participated in the study between 2011 and 2014, 29% of them being males (age 20.8 ± 5.1 years) and 71% females (age 20.3 ± 4.4 years). The prevalence of Problematic Internet Use (PIU) assessed by the Internet Addiction Test was 6.08%. Being under 21 years of age and studying for degrees in subjects other than the health sciences were associated factors with a higher frequency of this problem, no differences by gender or type of address were found. The results show a significant association with some health problems (migraines, back pain, excess weight or obesity, insufficient rest), psychological aspects (risk of eating disorders, risk of mental disorder, depression), family problems and discrimination; with no associations with substance use (alcohol, cannabis or tobacco) being found. Concerning the time of Internet use, weekly hours were significantly higher in women than in men, both the total time as for leisure. The analysis of the profile use in problematic users revealed that males are related to aspects of entertainment such as games or shopping online and females are related to aspects of socialization, such as chats and social networks. Uso problemático de internet en estudiantes universitarios: factores asociados y diferencias de géneroProblematic Internet Use in University Students: associated factors and differences of gender Tania Fernández-Villa*, Juan Alguacil Ojeda**,***, Ana Almaraz Gómez****, José María Cancela Carral*****, Miguel Delgado-Rodríguez**,******, Miguel García-Martín*******, Eladio Jiménez-Mejías*******, Javier Llorca**,********, Antonio José Molina*,*********, Rocío Ortíz Moncada**********, Luiz Félix Valero-Juan***********, Vicente Martín*,**,********* *Departamento de Ciencias Biomédicas. Área de Medicina Preventiva y Salud Pública. Universidad de León; **Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP); ***Centro de Investigación en Salud y Medio Ambiente (CYSMA). Universidad de Huelva; ****Departamento de Medicina Preventiva y Salud Pública, Universidad de Valladolid; *****Grupo de Investigación Healthy Fit. Facultad de Ciencias de la Educación y el Deporte. Universidad de Vigo; ******Área de Medicina Preventiva y Salud Pública. Universidad de Jaén; *******Departamento de Medicina Preventiva y Salud Pública. Universidad de Granada; ********Universidad de Cantabria -IDIVAL; *********Grupo de Investigación de Interacción Gen-Ambiente-Salud (GIIGAS). Universidad de León; **********Grupo de Investigación Alimentación y Nutrición, Área de Medicina Preventiva y Salud Pública. Universidad de Alicante.; ***********Área de Medicina Preventiva y Salud Pública. Universidad de Salamanca.

Background To identify and quantify associations between baseline characteristics on hospital admission and mortality in patients with COVID-19 at a tertiary hospital in Spain. Methods and findings This retrospective case series included 238 patients hospitalized for COVID-19 at Hospital Universitario Clínico San Cecilio (Granada, Spain) who were discharged or who died. Electronic medical records were reviewed to obtain information on sex, age, personal antecedents, clinical features, findings on physical examination, and laboratory results for each patient. Associations between mortality and baseline characteristics were estimated as hazard ratios (HR) calculated with Cox regression models. Series mortality was 25.6%. Among patients with dependence for basic activities of daily living, 78.7% died, and among patients residing in retirement homes, 80.8% died. The variables most clearly associated with a greater hazard of death were age (3% HR increase per 1-year increase in age; 95%CI 1-6), diabetes mellitus (HR 2.42, 95%CI 1.43-4.09), SatO 2 / FiO 2 ratio (43% HR reduction per 1-point increase; 95%CI 23-57), SOFA score (19% HR