Catalan Population Research Articles

Characteristics of Non-Therapeutic Pregabalin Users Detected by a Community Pharmacies Network in a Region of Southern Europe.

Background: Since 2008, several cases of pregabalin abuse have been reported to the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA). Despite this evidence, gabapentinoids are increasingly being prescribed. Moreover, pregabalin is being used in a recreational setting for its dissociative effects and euphoria. Objectives: To assess the characteristics of non-therapeutic users of pregabalin and to show behavioral trends associated with requests for the medicine at community pharmacies. Methods: The Medicine Abuse Observatory (MAO), an epidemiological surveillance system, was able to analyze trends about the most diverted drugs and the behavioral patterns of the population from community pharmacies. We have conducted an observational and cross-sectional study from January 2022 to April 2023, to determinate trends in the behavior of patients who have requested pregabalin in the Catalan Sephanet. Results: Behavior with respect to sex was similar in all health problems, although one difference was raised when considering neuropathic pain, in which the females were more involved (72.7%), especially around 2.5 times more than the males (27.3%, p < 0.05). The study showed a potential recreational use related to patients aged <25 years and patients aged 25-35 years (p < 0.05). Neuropathic pain was mainly identified in patients >65 years. In 75% of the cases, there was a preceding prescription. Conclusions: This study underlines the evidence of non-therapeutic use of pregabalin among the Catalan population and the need to take control measures. Actions should be promoted, both at the level of prescription and dispensing, and focusing on education and knowledge about the risks that may appear with the use of pregabalin.

Introduction of nirsevimab in Catalonia, Spain: description of the incidence of bronchiolitis and respiratory syncytial virus in the 2023/2024 season.

Respiratory syncytial virus (RSV) causes most of the cases of bronchiolitis and thousands of deaths annually, particularly in infants less than 6months old. In Catalonia (Spain), infants born between April 2023 and March 2024 aged 0-6months during their first RSV season have been candidates to receive nirsevimab, the novel monoclonal antibody against RSV, since October 2023. We aimed to analyse the dynamics of all-causes bronchiolitis diagnoses and RSV community infections in the current season and compare them to pre-nirsevimab epidemics. We collected epidemiological data from the Information System for Surveillance of Infections in Catalonia (SIVIC) on daily all-causes bronchiolitis clinical diagnoses and RSV-confirmed cases provided by rapid antigen tests in primary care practices. We calculated the rate ratio (RR) for the incidence of all-causes bronchiolitis for children aged 0-11m-old with respect to 12-35m-old between September 2014 and January 2024. We analysed the RR of the incidence of RSV-confirmed infection for 0-11m-old and 12-35m-old with respect to the > 35m-old, from January 2021 to January 2024. We then computed the relative difference of the RR, designated as percentage of reduction of risk, between season 2023/2024 and former epidemics. With a global coverage recorded rate for nirsevimab of 82.2% in January 2024, the age-specific 0-11m-old RR (95% CI) of RSV infection incidence for > 35m-old was 1.7 (1.5-2.0) in season 2023/2024. The RR (95% CI) had been 7.4 (5.6-9.9), 8.8 (6.9-11.3), and 7.1 (5.7-8.9) in 2020/2021, 2021/2022, and 2022/2023, respectively. Regarding the incidence of all-causes bronchiolitis for the 0-11m-old group compared to the 12-35m-old, the pre-pandemic (2014/2015-2019/2020) and 2022/2023 RR (95% CI) were 9.4 (9.2-9.6) and 6.0 (5.7-6.2), respectively, significantly higher than the RR of 3.6 (3.4-3.8) for the most recent season, 2023/2024. Conclusion: Concurring with the introduction of nirsevimab, the risk of RSV infection for infants aged 0-11m-old compared to > 35m-old has been reduced by 75.6% (73.4-77.5) in last season, and the risk for all-causes bronchiolitis for 12-35m-old by 61.9% (60.9-62.9) from the pre-pandemic period and by 39.8% (39.3-40.2) from the 2022/2023 epidemic, despite high RSV community transmission, especially in older infants What is Known: • RSV is responsible for approximately 70% of bronchiolitis cases and causes severe disease, particularly in infants < 6months of age. • Nirsevimab effectiveness against RSV-associated disease, particularly hospitalisations, was expected to be around 80%; other Spanish regions, such as Galicia and Valencia, and European countries including Luxembourg and Germany, have already reported good results in implementing nirsevimab to prevent RSV-associated hospitalisations and PICU stays. What is New: • We provide insight into the community incidence of RSV and all-causes bronchiolitis for season 2023/2024, when nirsevimab has been introduced to the Catalan population, using. primary healthcare data, which enabled us to assess the burden of RSV infections and bronchiolitis in the commonly seasonally saturated primary healthcare practices. • Our study reveals that the risk of all-causes bronchiolitis for infants aged 0-11m-old compared to older infants was reduced by 40% compared to the previous season and 62% compared to pre-pandemic standards, and for RSV infection it was reduced by 76%.

Prevalence of Atopic Dermatitis in the Adult Population of Catalonia, Spain: A Large-Scale, Retrospective, Population-Based Study.

Studies on the prevalence of atopic dermatitis (AD) in adults in general populations are scarce worldwide. We performed a retrospective population-based observational cohort study of 537 098 adult patients diagnosed with AD in Catalonia, Spain, a larger population than in previous studies. Objectives: To study the prevalence of AD by age, sex, disease severity, multimorbidity, serum total immunoglobin E (tIgE), and appropriate medical treatment (AMT) for the population of Catalonia. The study population comprised adult individuals (≥18 years) diagnosed with AD according to medical records at different health care levels (primary, hospital, emergency) in the Catalan Health System. Statistical analyses were conducted to evaluate sociodemographic characteristics, prevalence, multimorbidity, serum tIgE, and AMT. The prevalence of AD in the adult Catalan population was 8.7%, being higher for nonsevere disease (8.5%) than for severe disease (0.2%) and in females (10.1%) than in males (7.3%). Topical corticosteroids were the most prescribed drug (66.5%), and treatment was prescribed more frequently in severe AD patients, especially systemic corticosteroids (63.8%) and immunosuppressants (60.7%). More than half of severe AD patients (52.2%) had serum tIgE ≥100 kU/L, and higher values were observed for those with multimorbidity. The most frequent comorbid respiratory diseases were acute bronchitis (13.7%), allergic rhinitis (12.1%), and asthma (8.6%). We provide new and robust evidence of the prevalence of AD and related characteristics in adults using a large-scale population-based study and a more significant cohort of individuals.

Impacts of COVID-19 on clinical indicators and mortality in patients with chronic conditions in Catalonia, Spain: A retrospective population-based cohort study.

The reallocation of health care services during the coronavirus disease 2019 (COVID-19) pandemic disrupted the continuity of primary care. This study examines the repercussions of the COVID-19 pandemic on clinical indicators within the Catalan population, emphasising individuals with chronic conditions. It provides insights into mortality and transfer rates considering intersectional perspectives. We designed a retrospective, observational population-based cohort study based on routinely collected data from January 2015 to June 2021 for all individuals available in the Information System for Research in Primary Care (Sistema d'Informació per al Desenvolupament de la Investigació en Atenció Primària (SIDIAP)), the largest public primary care database in Catalonia, Spain. We included 6 301 095 individuals, constituting 81.6% of Catalonia's population in 2020. To perform a repeated measurements analysis of the indicators, we focussed on individuals who had one or more indicators in both the pre-pandemic (January 2015 to March 2020) and pandemic periods (March 2020 to June 2021), and those diagnosed with type 2 diabetes mellitus (T2D), high blood pressure, and heart failure. We selected key clinical indicators for analysis, including systolic and diastolic blood pressure, body mass index (BMI), cholesterol (total, high, and low-density lipoprotein), triglycerides, glycosylated haemoglobin, the Barthel index, and cardiovascular risk (Registre Gironí del cor (REGICOR) index). Mortality and transfer rates increased during the pandemic, contributing to a decline in the active population in the public health system. We also observed a reduction in pandemic period prevalence of patients with chronic conditions: -26.7% for heart failure, -15.1% for high blood pressure, and -14.6% for T2D. In both pre-pandemic and pandemic periods, 1 632 013 subjects had at least one clinical indicator record. Clinical indicators worsened in patients diagnosed with chronic conditions during the pandemic. Most indicators worsened, with differences between men and women (+9.4% vs +3.7% for the REGICOR index and -14.1% vs -16.6% for the Barthel index in men and in women, respectively), and to a similar extent (or greater in some cases) in individuals without these conditions. We used longitudinal data to assess the repercussions of the COVID-19 pandemic on population health while considering a wide range of clinical indicators and socioeconomic determinants. Our analysis shows a deterioration in clinical indicators during the pandemic, particularly in cardiometabolic factors, underscoring the importance of continuous primary care for individuals with chronic conditions.

Public International Law and the Catalan Secession Process

AbstractThis article briefly identifies the aspects of public international law related to the Catalan secession process, bearing in mind that Spain is a constitutional social and democratic state governed by the rule of law and a member of both the European Union (EU) and the Council of Europe (CoE). Over 6 years ago, on 27 October 2017, the regional Catalan Parliament proclaimed the independence of the Autonomous Community of Catalonia. From the start, the most recondite stratum of the Catalan pro-independence strategy has consistently invoked international law considerations with no real basis. Here we explain why. First, given the function of state sovereignty (today humanized and, in the context of the EU and CoE, democratized), under international law, these events can only be classified as a secession process (stricto sensu), that is, a revolutionary act in the constitutional order of the state of Spain with undertones that are far from peaceful. Second, we address the facet of the Catalan pro-secession strategy – typical of populist policies today – consisting of abusing terms and concepts, a language policy that, in our view, was and still is intended to win the minds of both the Catalan population and any other uninformed external observers. Finally, we examine how statehood is acquired under international law and its relationship to the 2017 declaration of Catalan independence and the present-day situation.

COVID-19 Incidence and Mortality in Patients Operated on for Breast Cancer. Comparison with the General Population

BackgroundBreast Cancer (BC) remains the most diagnosed malignancy and the most common cause of cancer-related mortality in women worldwide. Covid-19 mortality in BC patients has been linked to comorbid conditions rather than to cancer treatment itself, although this was not confirmed by a meta-analysis. Also, during Covid-19 outbreaks, a great deal of health care resources is reassigned to critical Covid-19 patients. Patients and MethodsDuring 5 consecutive trimesters (from 1/12/2020 to 31/3/2021) 2511 BC patients older than 20 years from our institution were surveyed. 1043 of them had received a Covid test and these made our study group, which was conveniently compared with the Covid-19 tested background feminine Catalan population. Results13.1% of our patients presented with a positive Covid-19 test, whereas confirmed COVID-19 infection amounted to 7.1% of the feminine Catalan tested population. The COVID-19-specific mortality rate was 11.7% (16/137) in the study group, which compares with a 4.7% rate for the overall population. Most deaths occurred in patients over 70. ConclusionThree clinical factors were significantly associated with Covid-19 mortality in BC, namely lack of hormone therapy, distant metastases, and BC dwelling in nursing homes. BC patients are at a higher risk of Covid-19 infection and mortality in comparison with the reference group without BC.

Clinical practice guidelines for the optimization of hemato-oncological care: the ICOPraxis.

The Catalan Institute of Oncology (ICO) is a Comprehensive Cancer Center (CCC) responsible for the oncological care of 46% of the Catalan population. Given the increasing and ongoing approval of onco-hematological treatments, the professionals at the ICO decided to have clinical practice guidelines (called ICOPraxis) based on available evidence. In this report, we intend to share how the ICOPraxis has developed and what its impact has been in the 14years it has been running. In the 14years, since the project has been running, 17 clinical practice guidelines (some of them with several editions) have been prepared for major onco-hematology clinical conditions. These guidelines will be utilized in the four ICO centers (Girona, Badalona, Tarragona, and Hospitalet) and ICO works in a network with 18 regional hospitals. Between 2018 and 2022, the guidelines have been viewed 38.645 times and downloaded 24.614 times, with an average time spent on each page of 3min. The ICOPraxis have been consulted in 25 countries in America (3.163 views), 20 countries in Europe (35.365 views), 10 countries in Asia (36 views), and 3 countries in Africa (12 views). The country with the highest number of downloads is Spain with a total of 34.742 downloads (Analytics [Internet]). The ICOPraxis have succeeded in establishing an evidence-based system that facilitates prescription decision-making according to the established harmonization process and reduction in variability in treatments, increasing equity in our population.

The Catalan Surveillance Network of SARS-CoV-2 in Sewage: design, implementation, and performance

Wastewater-based epidemiology has shown to be an efficient tool to track the circulation of SARS-CoV-2 in communities assisted by wastewater treatment plants (WWTPs). The challenge comes when this approach is employed to help Health authorities in their decision-making. Here, we describe the roadmap for the design and deployment of SARSAIGUA, the Catalan Surveillance Network of SARS-CoV-2 in Sewage. The network monitors, weekly or biweekly, 56 WWTPs evenly distributed across the territory and serving 6 M inhabitants (80% of the Catalan population). Each week, samples from 45 WWTPs are collected, analyzed, results reported to Health authorities, and finally published within less than 72 h in an online dashboard (https://sarsaigua.icra.cat). After 20 months of monitoring (July 20–March 22), the standardized viral load (gene copies/day) in all the WWTPs monitored fairly matched the cumulative number of COVID-19 cases along the successive pandemic waves, showing a good fit with the diagnosed cases in the served municipalities (Spearman Rho = 0.69). Here we describe the roadmap of the design and deployment of SARSAIGUA while providing several open-access tools for the management and visualization of the surveillance data.

Evolución de la prevalencia de arteriopatía periférica en la práctica clínica: Estudio descriptivo poblacional con bases de datos reales (SIDIAP-CMBD)

ObjectiveTo evaluate, with real world data (SIDIAP and CMBD), the evolution of the prevalence of peripheral arterial disease (PAD) in the Catalan population and the cardiovascular risk factors present in people with this pathology. DesignLongitudinal descriptive population study. SitePrimary health care. ParticipantsPatients listed in SIDIAP and CMBD with a diagnosis of peripheral artery disease between 2008 and 2018 ≥ 35 years, as well as those without a diagnosis, but with an ABI < 0.9 in SIDIAP. Interventions and main measurementsMain variable AP (ICD-9, ICD-10). Sociodemographic data, risk factors and cardiovascular disease, drug use and prevalent cardiovascular events at the time of diagnosis. Results141,520 patients were studied. 75% had hypertension, 58% were smokers or former smokers, and 23% had a myocardial infarction. The global prevalence increased from 1.15% in 2008 to 3.10% in 2018. The prevalence of PAD increased with age, with a moderate increase at younger ages, and more pronounced in > 55 years, exceeding 10% in > 85 years. ConclusionThis is a population study where it is observed that the evolution of the prevalence of peripheral artery disease has presented a constant increase during the years 2008–2018, being higher in men, especially from 55 years of age. Studies with large databases can facilitate the design and implementation of new policies in national health systems.

Levels of microplastics and their characteristics in molluscs from North-West Mediterranean Sea: Human intake

Microplastics (MPs) are accessible for organisms with active filter feeding strategies, as are many marine molluscs, which live attached or semi-buried in sediments. In the present study, MPs (from 0.02 to 5 mm) concentration, morphology, and composition were determined in consumed mollusc species of the Catalan coast (NW Mediterranean Sea). Microplastic concentrations, morphologic characteristics and composition were studied according to species, catchment zones and depuration condition. Finally, human intake of MPs through molluscs' consumption was determined. >2300 individuals were analysed, being 1460 MPs extracted and their size, and polymeric composition registered. Big oysters and mussels showed the highest MPs concentration by individual, with levels of 22.8 ± 14.4 and 18.6 ± 23.0 MPs/individual, respectively. Mean annual MPs (≥20 μm) consumption for adult population was estimated in 8103 MPs/year, with a 95th percentile of 19,418 MPs/year. It suggests that the consumption of molluscs is an important route of MPs exposure for the Catalan population.

Cancer diagnosis in Catalonia (Spain) after two years of COVID-19 pandemic: an incomplete recovery

BackgroundThis study aimed to estimate potential undetected cancers over the first 2 years of the COVID-19 pandemic in Catalonia.MethodsCancer incidence was compared between pre-pandemic (2019) and pandemic (March 2020-January 2022) periods in the Catalan Pathology Registry (CPR) according to sex, age, and tumor site. The correlation between cancer diagnosis and COVID-19 health care workload was also evaluated by means of the Pearson's correlation coefficient (R). The expected incident cancers (E) during the pandemic were estimated by applying 2019 CPR cancer incidence specific rates by sex and 5-year age groups to the 2020 and 2021 Catalan population pyramids. CPR incident cancers were considered observed (O). Standardized incidence ratios (SIR) and 95% confidence intervals (CIs) were calculated using the O/E ratio.ResultsAfter two pandemic years, cancer diagnosis decreased by 12% (SIR 0.88, 95% CI 0.87-0.89), or ∼7700 undetected cancers (13 000 with nonmelanoma skin cancer). Without nonmelanoma skin cancer, 72% of the cancer underdiagnosis was generated in 2020. Diagnoses decreased more in men (whole pandemic −14%; 2020 −21%; 2021 −8%) than in women (−9%, −19%, −3%, respectively), dropping significantly overall in all pandemic waves but the fifth (first −37%, second −16%, third −8%, fourth −6%, fifth −2%, sixth −6%), and across all adult age groups. In the first wave, CPR cancer diagnosis was inversely correlated with COVID-19 caseload in primary care (R −0.91, 95% CI −0.97 to −0.75) and occupancy in conventional hospital wards (R −0.91, 95% CI −0.99 to −0.48) and intensive care (R −0.91, 95% CI 95% −0.98 to −0.70).ConclusionsOur study evaluated the overall pandemic impact on cancer diagnosis on a large scale and with minimal selection bias, showing that as of February 2022, cancer detection in Catalonia had not yet recovered to pre-pandemic levels. Pending cancer incidence data from population-based cancer registries, early CPR data could inform the development of Spanish cancer control plans.

Decreasing prevalence of chronic back pain in Catalonia. Analysis of the Catalan Health Survey

ObjectivesChronic back pain is one of the main health problems reported by the adult population and its prevalence is influenced by different sociodemographic, work and lifestyle-related factors. The aim of this study was to describe the trend in the lifetime prevalence of chronic back pain in the adult Catalan population between 2011 and 2018 and its associated factors. Study designCross-sectional study. Secondary analysis of a health survey. MethodsTrend in lifetime prevalence of chronic back pain by age and sex groups was estimated from the Catalan Health Survey. Association of chronic back pain with sex, age, health status, lifestyle factors, comorbidities, socio-economic and work-related variables was analysed. ResultsA total of 31,823 people were interviewed between 2011 and 2018. The prevalence of chronic back pain decreased from 29.7% to 24.2% between 2011–2014 and 2015–2018 in the total population with higher prevalence and a greater difference in women (35%–28.50%) than in men (24.2%–19.7%). Factors associated with higher prevalence of chronic back pain were female sex, older age, poor health status, smoking, alcohol consumption, insufficient physical activity, overweight or obesity, mental health problems, lower educational level or social class, dissatisfaction at workplace, poor social support and family financial problems. ConclusionsThe analysis shows a decreasing prevalence of chronic back pain from 2011 to 2018 in the adult population of Catalonia in all age groups and more significantly in women. An improvement of healthy lifestyle habits, social and occupational determinants, could have reduced the burden of chronic back pain in our community.

Epidemiology of major osteoporotic fractures: a population-based analysis in Catalonia, Spain.

The aim of this study was to estimate the incidence of major osteoporotic fractures in Catalonia, Spain, in 2018 and 2019 and their association with age, sex, income, climate and a set of comorbidities. Data on age, sex, smoking, alcohol abuse, comorbidities (obesity, Parkinson's disease, arthritis, chronic kidney disease, hepatic cirrhosis, diabetes, chronic obstructive pulmonary disease, dementia, cerebrovascular disease, hyperthyroidism, multiple myeloma and epilepsy) and income levels in people aged ≥ 50years with a new diagnosis of major osteoporotic fractures in 2018 and 2019 were collected from the Catalan Health Surveillance System (CHSS). Climatological variables were obtained from the Catalan Meteorological Service. Incidence rates were estimated for five major osteoporotic fractures (MOF). Associations between osteoporotic fractures and age, sex, income, comorbidities and climate variables were ascertained through multilevel generalized linear model analysis (Poisson's regression). There were 60,671 MOF. The annual incidence rate per 1000 persons/years at risk (PYAR) was 10.6 (3.1 for hip, 2.3 for distal forearm, 2.2 for vertebrae, 1.7 for pelvis and 1.5 for proximal humerus). Female sex, older age, lower income, smoking, alcohol abuse and some common comorbidities were associated with a higher incidence of MOF while obesity was a protective factor. MOF are frequent in the adult Catalan population, especially in older women and people on low incomes. Hip fracture is the most frequent, followed by forearm and vertebral fractures. Smoking, alcohol abuse and some comorbidities were associated with an increased incidence of fracture.

Challenging the Gender Gap in Political Interest

Abstract Embedding randomized experiments in representative surveys of the Catalan population, this article shows that the survey instrument commonly used to measure citizens’ interest in politics is far from gender-neutral. By implicitly associating the political to male-oriented issues and male-dominated actors and domains, it artificially amplifies the gender gap, particularly by depressing women’s reported interest. The first experiment captures respondents’ interest through both the standard question about general political interest and a battery of specific political issues, randomizing question order. In the second experiment, an additional text helps reformulate the standard question by prompting respondents to think about politics in broader terms, randomizing the presentation of male-oriented and female-oriented political issues to test the effect of cognitive accessibility and recency. By expanding the conceptualization of the political, the priming applied in our experiments completely closes the gender gap, thereby casting doubt on the validity of the traditional survey instrument.

State of child and adolescent mental health during the first wave of the COVID-19 pandemic and at the beginning of the 2020–2021 school year

IntroductionThe aim of this project was to evaluate the psychopathological impact of home confinement and school closing between March and September 2020 on the mental health of Catalonian children. MethodsPEDSAME study: first cross-sectional section (beginning of the school year) and retrospective data (lockdown), carried out through the network of Primary Care pediatricians in the Catalan population between 5 and 14 years (included) from 09/14/2020 to 10/30/2020 in a random sample. Data were collected with an online survey through the RedCap platform at the beginning of the school year. The main variable was the result of the Strengths and Difficulties Questionnaire answered by parents to assess the risk of psychopathology, in addition to other related variable. ResultsThe results obtained at the beginning of the school year show that 9.8% of the patients were probable cases of psychopathology. The most affected group were those between 5 and 8 years. The perception of the children's level of concern for their health and that of their family was a risk factor for presenting psychopathology, while the good family environment was a protective factor. Emotional and behavioral symptoms, sleep disorders and problematic use of screens were detected more frequently during confinement than at the beginning of the school year. ConclusionsConfinement and the absence of schooling for 6 months had a negative impact on the mental health of the child–adolescent population who showed worse indicators than the previous year.

Estado de la salud mental infantojuvenil durante la primera ola de la pandemia de la COVID-19 y en el inicio del curso escolar 2020-2021

IntroductionThe aim of this project was to evaluate the psychopathological impact of home confinement and school closing between March and September 2020 on the mental health of Catalonian children. MethodsPEDSAME study: first cross-sectional section (beginning of the school year) and retrospective data (lockdown), carried out through the network of Primary Care pediatricians in the Catalan population between 5 and 14 years (included) from 09/14/2020 to 10/30/2020 in a random sample. Data were collected with an online survey through the RedCap platform at the beginning of the school year. The main variable was the result of the Strengths and Difficulties Questionnaire answered by parents to assess the risk of psychopathology, in addition to other related variable. ResultsThe results obtained at the beginning of the school year show that 9.8% of the patients were probable cases of psychopathology. The most affected group were those between 5 and 8 years. The perception of the children's level of concern for their health and that of their family was a risk factor for presenting psychopathology, while the good family environment was a protective factor. Emotional and behavioral symptoms, sleep disorders and problematic use of screens were detected more frequently during confinement than at the beginning of the school year. ConclusionsConfinement and the absence of schooling for 6 months had a negative impact on the mental health of the child–adolescent population who showed worse indicators than the previous year.

Body Mass Index and Risk of COVID-19 Diagnosis, Hospitalization, and Death: A Cohort Study of 2 524 926 Catalans.

ContextA comprehensive understanding of the association between body mass index (BMI) and COVID-19 is still lacking.ObjectiveTo investigate associations between BMI and risk of COVID-19 diagnosis, hospitalisation with COVID-19, and death after a COVID-19 diagnosis or hospitalisation (subsequent death), accounting for potential effect modification by age and sex.DesignPopulation-based cohort study.SettingPrimary care records covering >80% of the Catalan population, linked to region-wide testing, hospital, and mortality records from March to May 2020.ParticipantsAdults (≥18 years) with at least one measurement of weight and height.Main outcome measuresHazard ratios (HR) for each outcome.ResultsWe included 2 524 926 participants. After 67 days of follow-up, 57 443 individuals were diagnosed with COVID-19, 10 862 were hospitalised with COVID-19, and 2467 had a subsequent death. BMI was positively associated with being diagnosed and hospitalised with COVID-19. Compared to a BMI of 22kg/m 2, the HR (95%CI) of a BMI of 31kg/m 2 was 1.22 (1.19-1.24) for diagnosis, and 1.88 (1.75-2.03) and 2.01 (1.86-2.18) for hospitalisation without and with a prior outpatient diagnosis, respectively. The association between BMI and subsequent death was J-shaped, with a modestly higher risk of death among individuals with BMIs ≤19kg/m 2 and a more pronounced increasing risk for BMIs ≥40kg/m 2. The increase in risk for COVID-19 outcomes was particularly pronounced among younger patients.ConclusionsThere is a monotonic association between BMI and COVID-19 diagnosis and hospitalisation risks, but a J-shaped one with mortality. More research is needed to unravel the mechanisms underlying these relationships.

Risk Diagrams Based on Primary Care Electronic Medical Records and Linked Real-Time PCR Data to Monitor Local COVID-19 Outbreaks During the Summer 2020: A Prospective Study Including 7,671,862 People in Catalonia.

Monitoring transmission is a prerequisite for containing COVID-19. We report on effective potential growth (EPG) as a novel measure for the early identification of local outbreaks based on primary care electronic medical records (EMR) and PCR-confirmed cases. Secondly, we studied whether increasing EPG precedes local hospital and intensive care (ICU) admissions and mortality. Population-based cohort including all Catalan citizens' PCR tests, hospitalization, intensive care (ICU) and mortality between 1/07/2020 and 13/09/2020; linked EMR covering 88.6% of the Catalan population was obtained. Nursing home residents were excluded. COVID-19 counts were ascertained based on EMR and PCRs separately. Weekly empirical propagation (ρ7) and 14-day cumulative incidence (A14) and 95% confidence intervals were estimated at care management area (CMA) level, and combined as EPG = ρ7 × A14. Overall, 7,607,201 and 6,798,994 people in 43 CMAs were included for PCR and EMR measures, respectively. A14, ρ7, and EPG increased in numerous CMAs during summer 2020. EMR identified 2.70-fold more cases than PCRs, with similar trends, a median (interquartile range) 2 (1) days earlier, and better precision. Upticks in EPG preceded increases in local hospital admissions, ICU occupancy, and mortality. Increasing EPG identified localized outbreaks in Catalonia, and preceded local hospital and ICU admissions and subsequent mortality. EMRs provided similar estimates to PCR, but some days earlier and with better precision. EPG is a useful tool for the monitoring of community transmission and for the early identification of COVID-19 local outbreaks.

The impact of SARS-CoV-2 coronavirus infection in patients with systemic lupus erythematosus from a single center in Catalonia.

ObjectiveTo evaluate the incidence and characteristics of SARS-CoV-2 infection among patients with systemic lupus erythematosus (SLE) and to compare it to that described in the general population.MethodsFor 5 weeks, we carried out a cross-sectional study consisting of telephone interviews of SLE patients. We collected epidemiological data, symptoms suggesting COVID-19, results of nasopharyngeal swabs, and ongoing treatments. In those patients who required hospital admission, clinical, radiological, and laboratory features, and outcome were investigated.ResultsFour hundred patients with SLE completed the survey. Overall, 4 (1.00%, 95%CI 0.02–1.98) patients were classified as confirmed cases of COVID-19 and 26 (6.51%, 95%CI 4.08–8.94) as possible clinical cases. The incidence of confirmed cases in our series was similar to that of the Catalan population (1.00% versus 0.63%; p = 0.456), whereas the incidence of possible cases was higher in our series (6.51% versus 1.29%; p < 0.005). The only difference between SLE patients with confirmed and possible COVID-19 and those without was the percentage of patients who have had contact with a confirmed or possible case of COVID-19 (26.7% versus 9.2%; p = 0.003)ConclusionsThe incidence of COVID-19 in SLE patients with inactive disease is low and, in our series, all cases with confirmed infection recovered.Key Points• In a cohort of SLE patients with stable and clinical inactive disease, the incidence of COVID-19 is low.• All SLE patients with confirmed SARS-CoV-2 infection recovered.

PO-0815: Validation of a Prognostic Model for Predicting Larynx Preservation Outcome in Catalan Population.

PO-0815: Validation of a Prognostic Model for Predicting Larynx Preservation Outcome in Catalan Population.