SARS-COV-2 INFECTION IN PRIMARY CARE: A SINGLE-CENTERED, RETROSPECTIVE, OBSERVATIONAL STUDY

  1. Pilar Galicia García de Yébenes
  2. Juan José Gutiérrez Cuevas
  3. Fang Fang Chen Chen
  4. Laura Santos Larrégola
  5. Alberto Manzanares Briega
  6. Manuel Linares Rufo

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Abstract

Purpose

to describe the clinical characteristics of patients with confirmed SARS-CoV-2 infection in primary care and to analyze the predictive role of different risk factors on prognosis, especially living conditions.

Methods

Retrospective longitudinal observational retrospective study by reviewing medical records from a primary care center since March 1 to April 30, 2020. Case definition of confirmed SARS-CoV-2 infection, sociodemographic data, clinical characteristics, comorbidity and living conditions were collected. The statistical analysis consisted in description of the sample, comparison of prognosis groups and analysis of prognostic factors.

Results

A sample of 70 patients with confirmed SARS-CoV-2 infection was obtained, with comorbidity mainly related to arterial hypertension, overweight/obesity, hypercholesterolemia, diabetes and chronic pulmonary pathology. Pneumonia was present in 66%. Exitus occurred in 14% of the sample. Factors associated with mortality were advanced age (84 vs 55; p<0.0001), arterial hypertension (78% vs 41%; p=0.040), asthma-COPD (56% vs 13%; p=0.008) and atrial fibrillation (56% vs 5%; p=0.001).

Conclusions

The study reflects the clinical practice of a primary care center. This kind of studies are essential to strengthen and reorganize the Health System and to try to anticipate the medium- to long-term consequences of COVID-19 on global health.

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  1. ScreenIT

    SciScore for 10.1101/2021.11.30.21267074: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    EthicsIRB: The study was approved by the local Clinical Research Ethics Committee (Comisión Local de Investigación Sureste).
    Consent: As this is a retrospective study that does not involve a visit with the patient and the person who has access to the clinical history is the physician in charge, the CEICm was asked to waive informed consent for the patients.
    Sex as a biological variablenot detected.
    Randomizationnot detected.
    Blindingnot detected.
    Power AnalysisTherefore, there were no formal hypotheses being implemented to drive the sample size calculation and we included the maximum number of patients who met the inclusion criteria.

    Table 2: Resources

    No key resources detected.

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    This study presented has some strengths and is not without limitations. The main strength is its population base. Despite not including secondary care centers, it is very likely that the patients seen in PC centers are sufficiently representative, since it is the first gateway to the system. It is a population-based study and hospital care was not the first option for many patients during the months of highest virus circulation. The limitations also include problems of representativeness due to the peculiarities of the population of Vallecas, which cannot be extrapolated to other areas of Madrid, and the possible loss of more serious cases that went directly to the hospital. Another limitation of retrospective studies is the possibility of under-registration, which has been particularly striking in the variables on socioeconomic determinants. Finally, the small sample size and the loss of information on some variables have not allowed multivariate analysis of mortality determinants. Despite these limitations, we believe that the study reflects the reality of clinical practice and adequately describes the characteristics and risk factors of patients with COVID-19 infection in the PC setting. Knowledge of the burden of disease is of paramount importance at this level of care as it is the gateway to the system and has a key role in prevention, protection, promotion and treatment of individuals and communities. PC professionals are particularly concerned about the consequences of...

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

    Results from scite Reference Check: We found no unreliable references.

    About SciScore

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  2. Version published to 10.1101/2021.11.30.21267074v1 on medRxiv