Hospital at Home treatment with Remdesivir for patients with COVID-19: Real life experience.

Background : Access and appropriateness of therapeutics for COVID-19 vary due to access or regulatory barriers, severity of disease, and for some therapies, stage of the pandemic and circulating variants. Remdesivir has shown benefits in clinical recovery and is the treatment of choice for selected patients, both hospitalized and non-hospitalized, in main international guidelines. The use of Remdesivir in alternatives to conventional hospitalization such as Hospital at Home units remain incompletely explored. In this work, we aim to describe the real-life experience of outpatient remdesivir infusion for COVID-19 in a Hospital at Home unit. Methods : We selected all the consecutive patients receiving remdesivir from a prospective cohort of 507 COVID-19 patients admitted at a Hospital at Home unit. Admission criteria included COVID-19 with FiO2 requirement under 0.35 and respiratory rate under 22 rpm. Patients were daily assessed in-person by a nurse and a physician. Results : Two-hundred thirty-six patients admitted in HaH received remdesivir, from whom 172 were treated at home. Only 2% presented any adverse event related to the infusion, all of them mild. HaH saved 1416 day-beds, with only 5% of the patients requiring transfer back to hospital. Conclusions : Remdesivir infusion in Hospital at Home units seems to be a safe and efficient alternative to conventional hospitalization for treating non-severe COVID-19 patients

Medicalized Hotel as an Alternative to Hospital Care for Management of Noncritical COVID-19

Background: Since the first wave of COVID-19, alternatives to conventional hospitalization have been proposed for the provision of different levels of care, ranging from shelter during quarantine to hospital-level medical care. Objective: To describe the adaptation of a hotel by a hospital-at-home team to provide hospital-level care to patients with COVID-19 during the first wave of the pandemic in Barcelona, Spain. Methods: Hospital Clínic de Barcelona (HCB) is a 750-bed, public, tertiary teaching hospital serving 560 000 persons in the metropolitan area of Barcelona, Spain. In March 2020, the hospital-at-home unit was instructed to medicalize a hotel ('health hotel' [HH]) in downtown Barcelona. The aim of this initiative was to help decongest hospitals in the area by admitting patients with low dependency (Barthel Index score >60) and mild to severe COVID-19 from emergency departments or COVID-19 hospital wards, according to Centers for Disease Control and Prevention clinical guideline

Health outcomes from home hospitalization: multisource predictive modeling

Background: Home hospitalization is widely accepted as a cost-effective alternative to conventional hospitalization for selected patients. A recent analysis of the home hospitalization and early discharge (HH/ED) program at Hospital Clínic de Barcelona over a 10-year period demonstrated high levels of acceptance by patients and professionals, as well as health value-based generation at the provider and health-system levels. However, health risk assessment was identified as an unmet need with the potential to enhance clinical decision making. Objective: The objective of this study is to generate and assess predictive models of mortality and in-hospital admission at entry and at HH/ED discharge. Methods: Predictive modeling of mortality and in-hospital admission was done in 2 different scenarios: at entry into the HH/ED program and at discharge, from January 2009 to December 2015. Multisource predictive variables, including standard clinical data, patients’ functional features, and population health risk assessment, were considered. Results: We studied 1925 HH/ED patients by applying a random forest classifier, as it showed the best performance. Average results of the area under the receiver operating characteristic curve (AUROC; sensitivity/specificity) for the prediction of mortality were 0.88 (0.81/0.76) and 0.89 (0.81/0.81) at entry and at home hospitalization discharge, respectively; the AUROC (sensitivity/specificity) values for in-hospital admission were 0.71 (0.67/0.64) and 0.70 (0.71/0.61) at entry and at home hospitalization discharge, respectively. Conclusions: The results showed potential for feeding clinical decision support systems aimed at supporting health professionals for inclusion of candidates into the HH/ED program, and have the capacity to guide transitions toward community-based care at HH discharge.Peer ReviewedPostprint (published version

Estudio multicéntrico de intervención para la prevención de la exacerbación por Enfermedad Pulmonar Obstructiva Crónica. "APRENDEPOC"

Objetivo. Evaluar la efectividad de un programa de educación terapéutica a pacientes que ingresan por exacerbación de la EPOC con respecto a utilización de recursos, manejo signos y síntomas, mortalidad, calidad de vida relacionada con la salud (CVRS), parámetros ventilatorios y la adherencia al tratamiento

Cumplimiento normativo e integridad en entidades del sector público institucional de Catalunya : Informe final

Esta publicación es el resultado del proyecto sobre cumplimiento normativo e integridad pública que se ha desarrollado en el marco del convenio de colaboración firmado por la Oficina Antifraude de Cataluña, la Universidad de Castilla - La Mancha, la Universidad Autónoma de Barcelona, la Universidad de Santiago de Compostela y la Università degli studi di Modena e Reggio Emilia

GEODIVULGAR: Geología y Sociedad

Se incluyen los dos volúmenes resultantes de los concursos de relatos e Ilustración que han tenido lugar en el desarrollo del ProyectoDepto. de Geodinámica, Estratigrafía y PaleontologíaFac. de Ciencias GeológicasFALSEsubmitte