RESUMO
OBJECTIVES: The aim of this study was to evaluate the impact on 30-day mortality of early use of corticosteroids in COVID-19 patients with supplementary oxygen requirements and without invasive mechanical ventilation at the initiation of therapy. METHODS: All patients hospitalized with COVID-19 between April 15 and July 15, 2020, and requiring supplementary oxygen, were prospectively included in a database. Patients who died or required intubation within the first 48 hours were excluded. Patients who received corticosteroids within the first 5 days of hospitalization and at least 24 hours prior to intubation were allocated to the 'early corticosteroids' group. To compare both populations and adjust for non-random treatment assignment bias, a weight-adjusted propensity score model was used. RESULTS: In total, 571 patients met the inclusion criteria, 520 had sufficient information for the analysis. Of these, 233 received early corticosteroids and 287 did not. Analysis showed a reduction of 8.5% (p = 0.038) in 30-day mortality in the early corticosteroid group. The reduction in mortality was not significant when patients with corticosteroid initiation between day 5 and day 8 of hospitalization were included. CONCLUSION: Early corticosteroid use reduced mortality in patients with pneumonia due to COVID-19, who required supplementary oxygen but not initial invasive mechanical ventilation.
Assuntos
COVID-19 , Corticosteroides/uso terapêutico , Humanos , Pontuação de Propensão , Respiração Artificial , SARS-CoV-2 , EsteroidesRESUMO
Los académicos del Departamento de Fonoaudiología de la Universidad de Chile manifiestan una constante preocupación por mejorar la calidad de la educación profesional de sus estudiantes. Por ello, en el marco de la innovación curricular, han implementado dentro de la malla innovada una línea de trabajo para el desarrollo personal y profesional de habilidades comunicativas no verbales y verbales, en modalidad oral y escrita. En este artículo, se expone la fundamentación que sustenta la propuesta metodológica de dicha línea y su puesta en práctica. Además, se informa la fase en la que se encuentra la implementación de la propuesta y se comenta la necesidad de su evaluación.
Faculty in the Department of Communication Sciences and Disorders at the University of Chile constantly seeks to improve the quality of undergraduate education. In this regard, as part of a curriculum innovation process, a new educational curriculum was designed that includes an academic path aimed at developing personal and professional verbal and nonCverbal communication skills both in spoken and written modes of communication. This paper presents the rationale behind the design and implementation of this new academic path. Furthermore, an analysis of the current status of the implementation, which includes an evaluation of this process, is presented.