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Castillo Sánchez I, Camarasa JT, Barbeta Sánchez E, Oliveira VR. Clinical and functional status of patients with severe COVID-19 pneumonia: an observational study at 2-3 months following discharge. Front Rehabil Sci 2023; 4:1248869. [PMID: 37671070 PMCID: PMC10475945 DOI: 10.3389/fresc.2023.1248869] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Accepted: 08/07/2023] [Indexed: 09/07/2023]
Abstract
Introduction Critically ill COVID-19 patients present long-term sequelae that affect their everyday life. This study aimed to describe the clinical and functional status of patients with severe COVID-19 pneumonia at 2-3 months post discharge from a Spanish critical care unit. Methods We collected retrospective data from 58 patients admitted to the critical care unit with diagnosis of severe respiratory failure due to COVID-19. Only patients who required invasive (IMV) or noninvasive ventilation (NIV) during their hospital stay were included. The following data were collected 2-3 months after hospital discharge: respiratory signs and symptoms, lung ultrasound (LUS) and diaphragm ultrasound images, blood test analysis, lung function parameters (spirometry and DLCO), exercise capacity (6 min walk test and sit-to-stand test), level of physical activity and health-related quality of life. Results We found clinical symptoms and lung structural alterations in LUS images of 26 patients (48.1%). Those presenting LUS abnormalities had longer length of stay in hospital (p = 0.026), functional alterations in spirometry (p < 0.01) and decreased diaphragm excursion (p = 0.029). No significant alterations were observed in blood test analysis, exercise capacity, level of physical activity and health-related quality of life. Conclusions A significant part of the patients admitted to a critical care unit continue to present clinical symptoms, pulmonary morphological abnormalities, and lung function alterations 2-3 months post discharge. This study corroborates that assessing the functional status of the survivors is essential to monitor the evolution of pulmonary sequelae.
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Affiliation(s)
- Inmaculada Castillo Sánchez
- Pneumology Department, Granollers General Hospital, Barcelona, Spain
- Faculty of Health Sciences and Welfare, Universitat de Vic–Universitat Central de Catalunya (UVic-UCC), Vic, Spain
| | - Julia Tárrega Camarasa
- Pneumology Department, Granollers General Hospital, Barcelona, Spain
- Faculty of Medicine and Health Sciences, Universitat Internacional de Catalunya, Sant Cugat del Vallès, Spain
| | | | - Vinicius Rosa Oliveira
- Faculty of Health Sciences and Welfare, Universitat de Vic–Universitat Central de Catalunya (UVic-UCC), Vic, Spain
- Research Group on Methodology, Methods, Models and Outcomes of Health and Social Sciences (M3O), UVic-UCC, Vic, Spain
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Vico JP, Lorenzutti AM, Zogbi AP, Aleu G, Sánchez IC, Caffer MI, Rosmini MR, Mainar-Jaime RC. Prevalence, associated risk factors, and antimicrobial resistance profiles of non-typhoidal Salmonella in large scale swine production in Córdoba, Argentina. Res Vet Sci 2020; 130:161-169. [PMID: 32193003 DOI: 10.1016/j.rvsc.2020.03.003] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2018] [Revised: 02/04/2020] [Accepted: 03/02/2020] [Indexed: 11/15/2022]
Abstract
Non-typhoidal Salmonella is considered a major public health concern. The growing relevance of pigs as reservoir of Salmonella spp. has prompted several countries to set up surveillance and control programs to fight Salmonella infection in swine and reduce public health risk. In the last decade, pork production in Córdoba increased significantly to become one of the most important pig production provinces in Argentina. The aim of this study was to estimate Salmonella spp. prevalence and associated risk factors in large scale-farms in this province. Mesenteric lymph nodes (MLN) of 580 pigs from 20 finishing large-scale farms were collected between 2014 and 2015 to estimate Salmonella infection. A prevalence of 41.5% (95%CI: 37.6-45.6%) was observed. Two major risk factors were significantly associated with Salmonella infection, both related to the pre-slaughter period (distance from the farm to the slaughterhouse and lairage time), highlighting the need to pay special attention to pre-slaughter practices in the province. Shortening transport times and complying with national regulations for lairage time at slaughter may help to reduce the prevalence of infection. Sixteen different serovars were identified, being S. Anatum and S. Typhimurium the most prevalent ones. Moreover, two isolate of the monophasic variant of Salmonella Typhimurium (I 4,5,12:i:-) resistant to enrofloxacin and which also displayed multidrug resistance was isolated for first time from pigs in Córdoba. The moderate to high levels of antimicrobial resistance detected for antibiotics commonly used in the pig sector suggested the need for implementing a plan to limit their use in the province.
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Affiliation(s)
- J P Vico
- Instituto de Investigaciones en Recursos Humanos y Sustentabilidad, José Sánchez Labrador S.J IRNASUS-Conicet-Univesidad Católica de Córdoba, Facultad de Ciencias Agropecuarias, Veterinaria, Universidad Católica de Córdoba, Av. Armada Argentina 3555, X5016DHK Córdoba, Argentina.
| | - A M Lorenzutti
- Instituto de Investigaciones en Recursos Humanos y Sustentabilidad, José Sánchez Labrador S.J IRNASUS-Conicet-Univesidad Católica de Córdoba, Facultad de Ciencias Agropecuarias, Veterinaria, Universidad Católica de Córdoba, Av. Armada Argentina 3555, X5016DHK Córdoba, Argentina
| | - A P Zogbi
- Instituto de Investigaciones en Recursos Humanos y Sustentabilidad, José Sánchez Labrador S.J IRNASUS-Conicet-Univesidad Católica de Córdoba, Facultad de Ciencias Agropecuarias, Veterinaria, Universidad Católica de Córdoba, Av. Armada Argentina 3555, X5016DHK Córdoba, Argentina
| | - G Aleu
- Instituto de Investigaciones en Recursos Humanos y Sustentabilidad, José Sánchez Labrador S.J IRNASUS-Conicet-Univesidad Católica de Córdoba, Facultad de Ciencias Agropecuarias, Veterinaria, Universidad Católica de Córdoba, Av. Armada Argentina 3555, X5016DHK Córdoba, Argentina
| | - I C Sánchez
- Instituto de Investigaciones en Recursos Humanos y Sustentabilidad, José Sánchez Labrador S.J IRNASUS-Conicet-Univesidad Católica de Córdoba, Facultad de Ciencias Agropecuarias, Veterinaria, Universidad Católica de Córdoba, Av. Armada Argentina 3555, X5016DHK Córdoba, Argentina
| | - M I Caffer
- Servicio de Enterobacterias, Instituto Nacional de Enfermedades Infecciosas (INEI) - ANLIS "Dr. Carlos G. Malbrán", Avenida Velez Sarfield 563, C1282AFF Ciudad Autónoma de Buenos Aires, Argentina
| | - M R Rosmini
- Universidad Nacional del Litoral, Facultad de Ciencias Veterinarias, R.P. Kreder 2805, S3080HOF Esperanza, Santa Fe, Argentina
| | - R C Mainar-Jaime
- Departamento de Patología Animal, Facultad de Veterinaria, Instituto Agroalimentario de Aragón - IA2 - (Universidad de Zaragoza-CITA), Calle de Miguel Servet 177, 50013 Zaragoza, Spain
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