A primary care approach to the COVID-19 pandemic: clinical features and natural history of 2,073 suspected cases in the Corona São Caetano programme, São Paulo, Brazil

Leal, Fábio E.; Mendes-Corrêa, Maria Cássia; Buss, Lewis; Costa, Sílvia Figueiredo; Bizario, João C. S.; Souza, Sonia R P de; Thomaz, Osorio; Tozetto‐Mendoza, Tânia Regina; Villas-Boas, Lucy Santos; Silva, Lea Co; Grespan, Regina Maura Zetone; Capuani, Ligia; Buccheri, Renata; Domingues, Helves; Nast, Alexander; Mayaud, Philippe; Sabino, Éster Cerdeira

doi:10.1101/2020.06.23.20138081

Cited by 9 publications

(16 citation statements)

References 16 publications

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“…Many studies reported COVID‐19 hospitalizations, but only a few reported the relationship between individuals with obesity and hospitalization. We identified 19 studies that examined the relationship and included them in this analysis 1,28,38,40,44,47–58 . Table S4 presents the results 1,45,47,48,59,60 ; all showed a significantly higher prevalence of individuals with obesity among hospitalized patients than among patients not hospitalized or the general population.…”

Section: Epidemiological Relationships: Individuals With Overweight Amentioning

confidence: 99%

Individuals with obesity and COVID‐19: A global perspective on the epidemiology and biological relationships

et al. 2020

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Summary The linkage of individuals with obesity and COVID‐19 is controversial and lacks systematic reviews. After a systematic search of the Chinese and English language literature on COVID‐19, 75 studies were used to conduct a series of meta‐analyses on the relationship of individuals with obesity–COVID‐19 over the full spectrum from risk to mortality. A systematic review of the mechanistic pathways for COVID‐19 and individuals with obesity is presented. Pooled analysis show individuals with obesity were more at risk for COVID‐19 positive, >46.0% higher (OR = 1.46; 95% CI, 1.30–1.65; p < 0.0001); for hospitalization, 113% higher (OR = 2.13; 95% CI, 1.74–2.60; p < 0.0001); for ICU admission, 74% higher (OR = 1.74; 95% CI, 1.46–2.08); and for mortality, 48% increase in deaths (OR = 1.48; 95% CI, 1.22–1.80; p < 0.001). Mechanistic pathways for individuals with obesity are presented in depth for factors linked with COVID‐19 risk, severity and their potential for diminished therapeutic and prophylactic treatments among these individuals. Individuals with obesity are linked with large significant increases in morbidity and mortality from COVID‐19. There are many mechanisms that jointly explain this impact. A major concern is that vaccines will be less effective for the individuals with obesity.

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Section: Epidemiological Relationships: Individuals With Overweight Amentioning

confidence: 99%

Individuals with obesity and COVID‐19: A global perspective on the epidemiology and biological relationships

et al. 2020

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“…All other patients were offered a home visit for self-collection of a nasopharyngeal swab (NPS – both nostrils and throat), which were collected at the patients’ homes under the supervision of trained healthcare personnel. More details can be found in Leal et al(16). Due to shortages of some reagents, two RT-PCR platforms were used at different times during the study: ALTONA RealStar® SARS-CoV-2 RT-PCR Kit 1.0 (Hamburg, Germany) and the Mico BioMed RT-qPCR kit (Seongnam, South Korea).…”

Section: Methodsmentioning

confidence: 99%

“…For serology, we tested 10μL of serum or plasma (equivalent in performance) using a qualitative rapid chromatographic immunoassay (Wondfo Biotech Co., Guangzhou, China), that jointly detects anti-SARS172 CoV-2 IgG/IgM. The assay has been found to have a sensitivity of 81.5% and specificity of 99.1% in a U.S. study (16). In our local validation, after two weeks of symptoms, the sensitivity in RT-PCR confirmed cases (N=59) was 94.9%, and specificity in biobank samples (N=106) from 2019 was 100% (16).…”

Section: Methodsmentioning

confidence: 99%

Post-infection depression, anxiety and PTSD: a retrospective cohort study with mild COVID-19 patients

Ismael

Bizario²,

Battagin

et al. 2020

Preprint

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Background: It remains unclear whether COVID-19 is associated with psychiatric symptoms during or after the acute illness phase. Being affected by the disease exposes the individual to an uncertain prognosis and a state of quarantine. These factors can predispose individuals to the development of mental symptoms during or after the acute phase of the disease. There is a need for prospective studies assessing mental health symptoms in COVID-19 patients in the post-infection period. Methods: In this retrospective cohort study, nasopharyngeal swabs for COVID-19 tests were collected at patients homes under the supervision of trained healthcare personnel. Patients who tested positive for COVID-19 and were classified as mild cases (N=895) at treatment intake were further assessed for the presence of mental health disorders (on average, 56.6 days after the intake). We investigated the association between the number of COVID-19 symptoms at intake and depression, anxiety and PTSD, adjusting for previous mental health status, time between baseline and outcome, and other confounders. Multivariate logistic regression and generalized linear models were employed for categorical and continuous outcomes, respectively. Findings: Depression, anxiety and PTSD were reported by 26.2% (N=235), 22.4% (N=201), and 17.3% (N=155) of the sample. Reporting an increased number of COVID-related symptoms was associated with depression (aOR=1.059;95%CI=1.002-1.119), anxiety (aOR=1.072;95%CI=1.012-1.134), and PTSD (aOR=1.092;95%CI=1.024-1.166). Sensitivity analyses supported findings for both continuous and categorical measures. Interpretation: Exposure to an increased number of COVID-19 symptoms may predispose individuals to depression, anxiety and PTSD after the acute phase of the disease. These patients should be monitored for the development of mental health disorders after COVID-19 treatment discharge. Early interventions, such as brief interventions of psychoeducation on coping strategies, could benefit these individuals.

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“…We report the clinical characteristics and mortality rates of 23,844 patients diagnosed with COVID-19 in primary care, who constituted 6.84% of the population studied in the Central Catalan Region aged ≥16 years. This is one of only a few larger studies of COVID-19 patients conducted in primary care settings [25,27,28] and the only one to compare the characteristics and risk factors of patients diagnosed with COVID-19 with those of other patients without COVID-19 in the same health care area. Although there is no significant difference in age between patients with and without COVID-19, age is the main factor associated with mortality in patients with COVID-19, along with male sex, diabetes, dyslipidemia and heart failure.…”

Section: Principal Findingsmentioning

confidence: 99%

Clinical Characterization of Patients With COVID-19 in Primary Care in Catalonia: Retrospective Observational Study

Mayer¹,

Vidal-Alaball²,

Puigdellı́vol-Sánchez³

et al. 2021

JMIR Public Health Surveill

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Background The country of Spain has one of the highest incidences of COVID-19, with more than 1,000,000 cases as of the end of October 2020. Patients with a history of chronic conditions, obesity, and cancer are at greater risk from COVID-19; moreover, concerns surrounding the use of angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin type II receptor blockers (ARBs) and its relationship to COVID-19 susceptibility have increased since the beginning of the pandemic. Objective The objectives of this study were to compare the characteristics of patients diagnosed with COVID-19 to those of patients without COVID-19 in primary care; to determine the risk factors associated with the outcome of mortality; and to determine the potential influence of certain medications, such as ACEIs and ARBs, on the mortality of patients with COVID-19. Methods An observational retrospective study of patients diagnosed with COVID-19 in the Catalan Central Region of Spain between March 1 and August 17, 2020, was conducted. The data were obtained from the Primary Care Services Information Technologies System of the Catalan Institute of Health in Barcelona, Spain. Results The study population included 348,596 patients (aged >15 years) registered in the Primary Care Services Information Technologies System of the Catalan Central Region. The mean age of the patients was 49.53 years (SD 19.42), and 31.17% of the patients were aged ≥60 years. 175,484/348,596 patients (50.34%) were women. A total of 23,844/348,596 patients (6.84%) in the population studied were diagnosed with COVID-19 during the study period, and the most common clinical conditions of these patients were hypertension (5267 patients, 22.1%) and obesity (5181 patients, 21.7%). Overall, 2680/348,596 patients in the study population (0.77%) died during the study period. The number of deaths among patients without COVID-19 was 1825/324,752 (0.56%; mean age 80.6 years, SD 13.3), while among patients diagnosed with COVID-19, the number of deaths was 855/23,844 (3.58%; mean age 83.0 years, SD 10.80) with an OR of 6.58 (95% CI 6.06-7.15). Conclusions We observed that women were more likely to contract COVID-19 than men. In addition, our study did not show that hypertension, obesity, or being treated with ACEIs or ARBs was linked to an increase in mortality in patients with COVID-19. Age is the main factor associated with mortality in patients infected with SARS-CoV-2.

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A primary care approach to the COVID-19 pandemic: clinical features and natural history of 2,073 suspected cases in the Corona São Caetano programme, São Paulo, Brazil

Cited by 9 publications

References 16 publications

Individuals with obesity and COVID‐19: A global perspective on the epidemiology and biological relationships

Individuals with obesity and COVID‐19: A global perspective on the epidemiology and biological relationships

Post-infection depression, anxiety and PTSD: a retrospective cohort study with mild COVID-19 patients

Clinical Characterization of Patients With COVID-19 in Primary Care in Catalonia: Retrospective Observational Study

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