Individuals With SARS-CoV-2 Infection During the First and Second Waves in Catalonia, Spain: Retrospective Observational Study Using Daily Updated Data

Coronavirus SARS-CoV-2; COVID-19; 2019-nCoV; Epidemiologia; ComparacióCoronavirus SARS-CoV-2; COVID-19; 2019-nCoV; Epidemiología; ComparaciónCoronavirus SARS-CoV-2; COVID-19; 2019-nCoV; Epidemiology; ComparisonA description of individuals with SARS-CoV-2 infection comparing the first and second waves could help adapt health services to manage this highly transmissible infection.Objective: We aimed to describe the epidemiology of individuals with suspected SARS-CoV-2 infection, and the characteristics of patients with a positive test comparing the first and second waves in Catalonia, Spain. Methods: This study had 2 stages. First, we analyzed daily updated data on SARS-CoV-2 infection in individuals from Girona (Catalonia). Second, we compared 2 retrospective cohorts of patients with a positive reverse-transcription polymerase chain reaction or rapid antigen test for SARS-CoV-2. The severity of patients with a positive test was defined by their admission to hospital, admission to intermediate respiratory care, admission to the intensive care unit, or death. The first wave was from March 1, 2020, to June 24, 2020, and the second wave was from June 25, 2020, to December 8, 2020.Results: The numbers of tests and cases were lower in the first wave than in the second wave (26,096 tests and 3140 cases in the first wave versus 140,332 tests and 11,800 cases in the second wave), but the percentage of positive results was higher in the first wave than in the second wave (12.0% versus 8.4%). Among individuals with a positive diagnostic test, 818 needed hospitalization in the first wave and 680 in the second; however, the percentage of hospitalized individuals was higher in the first wave than in the second wave (26.1% versus 5.8%). The group that was not admitted to hospital included older people and those with a higher percentage of comorbidities in the first wave, whereas the characteristics of the groups admitted to hospital were more alike.This work was supported by grants from the European Union ERDF funds (Network for Prevention and Health Promotion in Primary Care, RedIAPP–CARDIOCAT; RD16/0007/0004) and from the Agency for Management of University and Research Grants (AGAUR; 2017-SGR 1146). We thank Eric Tornabell for his technical support. We also thank all health care professionals for their ceaseless work to care for COVID-19 patients in this pandemic

El nivell i la variació del risc cardiovascular en la prevenció primària de la demència

Dementia causes progressive cognitive impairment and inability to lead an independent life. Currently, there is no curative treatment for it, and thus primary prevention is essential. Age is the main risk factor for developing dementia and, with the progressive aging of society, it is necessary to have updated data to plan health services. Among the known risk factors, a large part are cardiovascular risk factors. We propose to study them in an integrated way with the cardiovascular risk equations. We have carried out a study to be able to validate dementia diagnoses from a large database that collects data from the primary care clinical history (SIDIAP) and thus, to be able to define the casuistry. We have also analyzed how the association between risk factors and dementia varies according to age and gender, from the age of 65. Finally, we have studied the effect of the level of cardiovascular risk with the REGICOR equation on the incidence of dementia. The results of our study have been satisfactory because they have allowed us extensively validate the dementia diagnoses registered in the SIDIAP database. Likewise, the study of the epidemiology of dementia has reported incidence results of 8.6 per 1,000 person-years (CI95% 8.0-9.3) and prevalence of 5.1% (CI95% 4.5%-5.7%). Both estimates were higher in women and the increase with age was more pronounced in women than in men. The results of study the effect of age and sex on the factors associated with dementia, have shown us that the variables most associated with dementia ranked in: Parkinson's disease, excessive alcohol consumption, depressive disorder, and history of cerebrovascular disease. Both sex and age influence the association between several of these risk factors and dementia. Finally, the results we consider to have the greatest impact have been those provided by the study of the incidence of dementia in relation to the REGICOR risk groups: this incidence increases as the cardiovascular risk increases. The groups with the highest REGICOR risk have an incidence of dementia of 10.19 (CI95% 9.98-10.41), and this is even higher in people with a history of cardiovascular disease, increasing to 12.28 (95% CI 12.05-12.50)La demència causa deteriorament cognitiu progressiu i incapacitació per portar una vida independent. No disposem d’un tractament curatiu i la seva prevenció primària és clau. Sabem que l’edat és el principal factor de risc per desenvolupar demència i, amb el progressiu envelliment de la societat, cal tenir dades actualitzades per planificar els serveis de salut. D’entre els factors de risc coneguts, una gran part són factors de risc cardiovasculars. Proposem estudiar-los de forma integrada amb les equacions de risc cardiovascular. Hem realitzat un estudi per a poder validar els diagnòstics de demència d’una gran base de dades que recull dades de la història clínica d’Atenció Primària (SIDIAP) i així, poder-ne definir la casuística. També hem analitzat l’associació entre factors de risc i demència i com varia segons l’edat i el sexe, a partir de 65 anys, i finalment, hem estudiat l’efecte del nivell del risc cardiovascular amb l’equació REGICOR sobre la incidència de demència. Els resultats del nostre estudi han estat satisfactoris perquè ens han permès validar àmpliament els diagnòstics de demència registrats a la base de dades SIDIAP. Així mateix, l’estudi de l’epidemiologia de la demència ens ha reportat resultats d’incidència de 8,6 per 1.000 persones–any (IC95% 8,0-9,3) i prevalença del 5,1% (IC95% 4,5%-5,7%). Ambdues més altes en les dones i amb un augment més pronunciat en dones que en homes a mesura que augmenta l’edat. Els resultats d’haver estudiat l’efecte de l’edat i el sexe en els factors associats a la demència, ens han mostrat que les variables més associades amb la demència han estat, per aquest ordre: la malaltia de Parkinson, el consum excessiu d’alcohol, el trastorn depressiu i els antecedents de malaltia cerebrovascular. I que tant el sexe com l’edat influeixen en l'associació entre diversos factors de risc i la demència. Finalment, els que considerem els resultats de major impacte han estat els proporcionats per l’estudi de la incidència de demència en relació al nivell de risc REGICOR: la incidència augmenta a mesura que augmenta el risc cardiovascular. Tant és així, que els grups amb risc REGICOR més elevat tenen una incidència de demència de 10,19 (IC95% 9,98-10,41), i aquesta encara és més alta en les persones amb antecedents de malaltia cardiovascular, augmentant fins a 12,28 (IC95% 12,05-12,50)Programa de Doctorat en Biologia Molecular, Biomedicina i Salu