Revisión de la situación epidemiológica actual y contexto histórico de la tularemia en España

La tularemia es una antropozoonosis causada por Francisella tularensis, cuyos principales reservorios en España son los lagomorfos y los roedores. En nuestro país la subespecie holarctica (también conocida como paleartica o tipo B) es el agente responsable. Es una enfermedad emergente en España, especialmente ligada a la comunidad autónoma de Castilla y León, donde han tenido lugar la mayoría de los casos. Aunque con posterioridad se descubrió que la infección en humanos ya existía en la península ibérica, fue en 1997, tras una epizoonosis de liebres, cuando tuvo lugar el primer brote epidémico con 559 casos confirmados (513 en Castilla y León). En 1998 se notificaron 19 casos en la provincia de Cuenca en relación a la manipulación de cangrejos de río. En 2007, coincidiendo con una plaga de topillos, tuvo lugar el último brote epidémico hasta la fecha, de 507 casos, y que afectó exclusivamente a Castilla y León. Aunque su letalidad y complicaciones son mínimas (ningún fallecido en España), el índice de ingresos ha sido alto debido a la poca experiencia en relación al manejo de esta enfermedad y a la alarma social que siempre se genera en el contexto de una epidemia de estas características.Grado en Medicin

Healthcare workers hospitalized due to COVID-19 have no higher risk of death than general population. Data from the Spanish SEMI-COVID-19 Registry

Aim To determine whether healthcare workers (HCW) hospitalized in Spain due to COVID-19 have a worse prognosis than non-healthcare workers (NHCW). Methods Observational cohort study based on the SEMI-COVID-19 Registry, a nationwide registry that collects sociodemographic, clinical, laboratory, and treatment data on patients hospitalised with COVID-19 in Spain. Patients aged 20-65 years were selected. A multivariate logistic regression model was performed to identify factors associated with mortality. Results As of 22 May 2020, 4393 patients were included, of whom 419 (9.5%) were HCW. Median (interquartile range) age of HCW was 52 (15) years and 62.4% were women. Prevalence of comorbidities and severe radiological findings upon admission were less frequent in HCW. There were no difference in need of respiratory support and admission to intensive care unit, but occurrence of sepsis and in-hospital mortality was lower in HCW (1.7% vs. 3.9%; p = 0.024 and 0.7% vs. 4.8%; p<0.001 respectively). Age, male sex and comorbidity, were independently associated with higher in-hospital mortality and healthcare working with lower mortality (OR 0.211, 95%CI 0.067-0.667, p = 0.008). 30-days survival was higher in HCW (0.968 vs. 0.851 p<0.001). Conclusions Hospitalized COVID-19 HCW had fewer comorbidities and a better prognosis than NHCW. Our results suggest that professional exposure to COVID-19 in HCW does not carry more clinical severity nor mortality

A retrospective analysis of incidence and severity of COVID-19 among hypertensive patients: the other side

Objective The role of hypertension in COVID-19 has not been clearly elucidated yet. The aim of this study was to evaluate the incidence and severity of COVID-19 in a hypertensive population and assess whether there is a link between blood pressure control and SARS-CoV-2 infection outcomes. Methods This was a single-center retrospective observational study that evaluated the incidence and severity of COVID-19 in a chronic hypertensive population (n=1,637) from a specialized consultation of Hypertension and Cardiovascular Risk of Internal Medicine in a tertiary hospital in Madrid (Spain). Results A total of 147 COVID-19 patients (9%) were found, with a median age of 59 (±14) years, where 77 (52.4%) patients were male. Forty patients required hospitalization (27.2%), 15 patients had severe COVID-19 (10.2%), and 6 patients died (4.1%). Among the causes of hypertension, 104 (70.7%) patients had essential hypertension and 22 (15%) patients presented primary hyperaldosteronism; and 66 (44.9%) patients presented RH. Severe COVID-19 was associated with age over 65 years (crude OR 4.43 [95% CI 1.3–14.2; p = .012]) and diabetes mellitus (crude OR 4.15 [95% CI 1.3–12.9; p = .014]). Conclusion This study showed a lower rate of incidence, hospitalization, and severity of COVID-19 in the hypertensive population