RESUMO
The aim of this study was to analyze whether the coronavirus disease 2019 (COVID-19) vaccine reduces mortality in patients with moderate or severe COVID-19 disease requiring oxygen therapy. A retrospective cohort study, with data from 148 hospitals in both Spain (111 hospitals) and Argentina (37 hospitals), was conducted. We evaluated hospitalized patients for COVID-19 older than 18 years with oxygen requirements. Vaccine protection against death was assessed through a multivariable logistic regression and propensity score matching. We also performed a subgroup analysis according to vaccine type. The adjusted model was used to determine the population attributable risk. Between January 2020 and May 2022, we evaluated 21,479 COVID-19 hospitalized patients with oxygen requirements. Of these, 338 (1.5%) patients received a single dose of the COVID-19 vaccine and 379 (1.8%) were fully vaccinated. In vaccinated patients, mortality was 20.9% (95% confidence interval [CI]: 17.9-24), compared to 19.5% (95% CI: 19-20) in unvaccinated patients, resulting in a crude odds ratio (OR) of 1.07 (95% CI: 0.89-1.29; p = 0.41). However, after considering the multiple comorbidities in the vaccinated group, the adjusted OR was 0.73 (95% CI: 0.56-0.95; p = 0.02) with a population attributable risk reduction of 4.3% (95% CI: 1-5). The higher risk reduction for mortality was with messenger RNA (mRNA) BNT162b2 (Pfizer) (OR 0.37; 95% CI: 0.23-0.59; p < 0.01), ChAdOx1 nCoV-19 (AstraZeneca) (OR 0.42; 95% CI: 0.20-0.86; p = 0.02), and mRNA-1273 (Moderna) (OR 0.68; 95% CI: 0.41-1.12; p = 0.13), and lower with Gam-COVID-Vac (Sputnik) (OR 0.93; 95% CI: 0.6-1.45; p = 0.76). COVID-19 vaccines significantly reduce the probability of death in patients suffering from a moderate or severe disease (oxygen therapy).
Assuntos
COVID-19 , Vacinas , Humanos , Vacinas contra COVID-19 , Oxigênio , ChAdOx1 nCoV-19 , Vacina BNT162 , Estudos de Coortes , Estudos Retrospectivos , COVID-19/prevenção & controle , RNA MensageiroRESUMO
RESUMEN Objetivo Traducir y adaptar culturalmente el cuestionario Exercise Fear Avoidance Scale (EFAS) al español para su uso en adultos mayores chilenos. Materiales y Métodos Doble traducción directa con armonización de versiones, retro-traducción y análisis de la comprensibilidad mediante entrevistas cognitivas. En el proceso de entrevistas cognitivas participaron 20 adultos mayores con edades comprendidas entre 63 y 83 años. Resultados Todos los ítems fueron evaluados como claros y comprensibles. Mediante la técnica de parafraseo e indagación 3 ítems (de un total de 16) se tuvieron que adaptar para lograr una mejor comprensión. Dos de estas adaptaciones consistieron en reemplazar un concepto por uno más utilizado en el contexto chileno y otra modificación fue en relación con la redacción, puesto que su lectura resultaba compleja para esta población. Conclusiones Se obtuvo una versión en español del cuestionario EFAS, la cual demostró ser comprensible y adaptada para su uso en adultos mayores chilenos.(AU)
ABSTRACT Objective To translate and culturally adapt the Exercise Fear Avoidance Scale (EFAS) Into Spanish for Chilean older adults. Materials and Methods Double direct translation with harmonization, back translation and analysis of text comprehensibility through cognitive interviews. A sample of 20 older adults between the ages of 63 and 83 participated in the cognitive interview process. Results All items were assessed as clear and understandable. Using the paraphrasing and inquiry techniques, 3 items (out of 16) were adapted to achieve better understanding. Two of these adaptations consisted in replacing one concept with another, as the latter was more used in the Chilean context, and making a non-literal translation, since the literal one was too complex for the elderly to understand. Conclusions A Spanish version of the EFAS was obtained, which proved to be understandable and adapted for its use with Chilean older adults.(AU)
OBJETIVO Traduza e adapte culturalmente o questionário da Escala de Evitação do Medo do Exercício (EFAS) ao espanhol para uso em idosos chilenos. MATERIAIS E MÉTODOS Tradução direta dupla com harmonização de versões, retrotradução e análise de compreensibilidade por meio de entrevistas cognitivas. Vinte idosos entre 63 e 83 anos participaram do processo de entrevista cognitiva. RESULTADOS Todos os itens foram avaliados como claros e compreensíveis. Usando a paráfrase e a técnica de investigação, três itens (de um total de 16) tiveram que ser adaptados para alcançar uma melhor compreensão. Duas dessas adaptações consistiram em substituir um conceito por outro mais utilizado no contexto chileno e outra modificação em relação à redação, uma vez que sua leitura era complexa para essa população. CONCLUSÕES Foi obtida uma versão em espanhol do questionário EFAS, que se mostrou compreensível e adaptado para uso em idosos chilenos.(AU)
Assuntos
Humanos , Idoso , Idoso de 80 Anos ou mais , Envelhecimento , Exercício Físico , Medo/psicologia , Chile , Inquéritos e QuestionáriosRESUMO
OBJECTIVE: To translate and culturally adapt the Exercise Fear Avoidance Scale (EFAS) Into Spanish for Chilean older adults. MATERIALS AND METHODS: Double direct translation with harmonization, back translation and analysis of text comprehensibility through cognitive interviews. A sample of 20 older adults between the ages of 63 and 83 participated in the cognitive interview process. RESULTS: All items were assessed as clear and understandable. Using the paraphrasing and inquiry techniques, 3 items (out of 16) were adapted to achieve better understanding. Two of these adaptations consisted in replacing one concept with another, as the latter was more used in the Chilean context, and making a non-literal translation, since the literal one was too complex for the elderly to understand. CONCLUSIONS: A Spanish version of the EFAS was obtained, which proved to be understandable and adapted for its use with Chilean older adults.
OBJETIVO: Traducir y adaptar culturalmente el cuestionario Exercise Fear Avoidance Scale (EFAS) al español para su uso en adultos mayores chilenos. MATERIALES Y MÉTODOS: Doble traducción directa con armonización de versiones, retro-traducción y análisis de la comprensibilidad mediante entrevistas cognitivas. En el proceso de entrevistas cognitivas participaron 20 adultos mayores con edades comprendidas entre 63 y 83 años. RESULTADOS: Todos los ítems fueron evaluados como claros y comprensibles. Mediante la técnica de parafraseo e indagación 3 ítems (de un total de 16) se tuvieron que adaptar para lograr una mejor comprensión. Dos de estas adaptaciones consistieron en reemplazar un concepto por uno más utilizado en el contexto chileno y otra modificación fue en relación con la redacción, puesto que su lectura resultaba compleja para esta población. CONCLUSIONES: Se obtuvo una versión en español del cuestionario EFAS, la cual demostró ser comprensible y adaptada para su uso en adultos mayores chilenos.