Dr. Alvarado-Livacic, Cristobal

Introducción: En los pacientes críticos con COVID-19 ocurren una serie de alteraciones metabólicas, las cuales afectan directamente el estado nutricional del paciente. Para mejorar la sobrevida de los pacientes con COVID-19, se hace relevante el tratamiento nutricional oportuno, idealmente dentro de las primeras 24-48 horas de la admisión a la UCI. El objetivo de este estudio fue reportar la evolución, desde el ingreso hasta el egreso, del balance nitrogenado, diversos parámetros bioquímicos y el estado nutricional de los pacientes con neumonía por COVID-19. Método: Estudio observacional retrospectivo de temporalidad longitudinal, se realizó en la UCI del Hospital Las Higueras de Talcahuano, Chile. Se incluyeron a 33 pacientes al ingreso y al egreso de la UCI. Resultados: Se reportó un incremento significativo del balance nitrogenado al egreso de los pacientes de UCI, sin embargo, no se registraron cambios en la media de talla, peso, IMC, prevalencia de desnutrición durante la estancia en la UCI. La prevalencia de desnutrición moderada y severa fue de un 14,0%, valor inferior al 45,0% informado en pacientes con COVID-19. Conclusión: En este estudio se reportó que la implementación del protocolo y la terapia nutricionales durante la pandemia de COVID-19 se asoció a un aumento del balance nitrogenado y un mejor control glicémico en los pacientes que egresan de la UCI por neumonía de COVID-19.

Background: The quality assessment of the home-based isolation and care program (HBIC) relies heavily on patient satisfaction and length of stay. COVID-19 patients who were isolated and received HBIC were monitored through telephone consultations (TC), in-person TC visits, and a self-reporting application. By evaluating patient satisfaction and length of stay in HBIC, healthcare providers could gauge the effectiveness and efficiency of the HBIC program. Methods: A cross-sectional study design enrolled 444 HBIC patients who answered a structured questionnaire. A binary logistic regression model assessed the association between independent variables and patient satisfaction. The length of stay in HBIC was analyzed using Cox regression analysis. The data collection started on April (1–30), 2022, in Addis Ababa, Ethiopia. Results: The median age was 34, and 247 (55.6%) were females. A greater proportion (313, 70.5%) of the participants had high satisfaction. Higher frequency of calls (>3 calls) (AOR = 2.827, 95% CI = 1.798, 4.443, p = 0.000) and those who were symptomatic (AOR = 2.001, 95% CI = 1.289, 3.106, p = 0.002) were found to be significant factors for high user satisfaction. Higher frequency of calls (>3 calls) (AHR = 0.537, 95% CI = 0.415, 0.696, p = 0.000) and more in-person visits (>1 visit) (AHR = 0.495, 95% CI = 0.322, 0.762, p = 0.001) had greater chances to reduce the length of stay in the COVID-19 HBIC. Conclusion: 70.5% of the participants had high satisfaction with the system, and frequent phone call follow-ups on patients’ clinical status can significantly improve their satisfaction and length of recovery. An in-person visit is also an invaluable factor in a patient’s recovery.