Relationship between initial symptoms and the prognosis, sex, and demographic area of patients with COVID-19

Abstract

BackgroundA method of determining the initial symptoms and main prognostic identifiers for COVID-19 can be a key tool for physicians, especially primary care physicians. Therefore, the objective of this study was to examine the prognosis of patients with COVID-19 from two different demographic regions according to baseline and main symptoms, age, and sex.MethodsAll individuals selected from both urban and rural health centers were over 18 years of age, had COVID-19 before 2 March 2021, and were followed up with a primary care physician. All patients included in this study were recruited in terms of sex, age at the time of infection, type of contact, baseline symptoms, primary and secondary symptomatology, emergency assistance, hospitalization, intensive care unit (ICU) admission, and death.ResultsA total of 219 and 214 subjects were recruited from rural and urban health centers, respectively. Subjects with COVID-19 from rural areas were significantly older in age, with a higher proportion of men, and had significantly lower baseline and main symptoms than those from urban areas. In addition, the presence of both fever and dyspnea as the initial or main symptom is significantly associated with emergency assistance, hospitalization, and death, regardless of sex, age, and demographic area. This type of illness was reported to be significantly less frequent in the rural population than in the urban population.ConclusionThe presence of both fever and dyspnea as both initial and main symptoms is a poor prognostic factor for COVID-19, regardless of age, sex, and demographic areas. In addition, women reported lower levels of fever and dyspnea, requiring minimal emergency assistance and fewer hospitalization, and a lower rate of mortality than men. During a COVID-19 infection follow-up, subjects in rural areas seem to have less access to medical care than those in urban areas.

Overdose mortality rates for opioids or stimulants are higher in males than females, controlling for rates of drug misuse: State-level data

“…As mentioned above, there has been an increase in overdoses due to synthetic opioids during recent years, especially 2020 and thereafter, coinciding with the COVID-19 pandemic [1,4,48]. COVID-19 mortality, which is greater in men versus women, also involves respiratory distress [49-51], and the presence of specific SUD is also noted as a risk factor for COVID-19 infection [51,52]. However, we are not aware of studies that examined if COVID-19 infection per se is involved in the increases in opioid-induced overdoses at the patient level (as opposed to the system-wide impact of multiple environmental, healthcare and patient-level changes that occurred during the pandemic) [51,53-57].…”

COVID-19 epidemiology and rural healthcare: a survey in a Spanish village

“…Local primary healthcare provided through Primary Care Teams (EAP in Spanish) in urban and rural settings has been fundamental in managing the COVID-19 pandemic in Spain. The EAP initially assesses the severity of the patient, establishing who requires follow-up from primary care or transfer to hospital care [5]. However, primary healthcare underwent changes during the pandemic, mostly in relation to the digitization of assistance through telephone consultation, telematics assistance, electronic prescription, or telematics work disability reports [8].…”

“…In the last decade, the registered urban population has increased by 2.1% in Spain, while the rural population has decreased by 7.1% due to emigration and deaths. Elsewhere, patients in rural areas have less access to medical care than those in urban areas [5], and socioeconomic inequalities as well as the place of residence influence the risk of COVID-19 [6]. The differences between urban and rural areas are also evidenced by psychotropic drug consumption, which increased during the COVID-19 pandemic, especially among women, the elderly, and in rural areas in relation to anxiety, insomnia, and depression [7].…”