Original Article

Clinical-epidemiological characterization of adult patients confirmed with COVID-19 in a medical office in Matanzas

Caracterización clínico-epidemiológica de pacientes adultos confirmados con COVID-19 en un Consultorio Médico en Matanzas

Yonathan Estrada Rodríguez1* https://orcid.org/0000-0001-9161-6545

Shania Naranjo Lima1 https://orcid.org/0000-0001-6248-2963

Karen Oviedo Pérez1 https://orcid.org/0000-0002-8501-0392

Carlos Luis Vinageras Hidalgo1 https://orcid.org/0009-0007-4848-1797

José Fernando Placeres Hernández1 https://orcid.org/0000-0001-6285-5029

Katherine Navarro Mantilla2 https://orcid.org/0009-0005-4067-6755

1 University of Medical Sciences of Matanzas. Faculty of Medical Sciences of Matanzas “Dr. Juan Guiteras Gener”. Matanzas, Cuba.

2 University of Matanzas. Matanzas, Cuba.

*Author for email: yonathanestrada010308@gmail.com

ABSTRACT

The testicular tumor forms in one or several testicles. It is more common in young or middle-aged men. Most testicular tumors begin to form in the germ cells (which become sperm) and are called a testicular germ cell tumor. The appearance of testicular germ cell tumors constitutes more than 90% of these cancers, for which it was decided to report the case of a young patient with a testicular tumor, diagnosed at the Saturnino Lora Provincial Hospital, Santiago de Cuba, in 2022, with the aim of describing it, for which 15 bibliographic references were consulted. The favorable response to oncospecific treatment of these tumors and their appearance in early stages of life require accurate and timely diagnosis. The first line treatment for testicular tumor is surgery to remove the tumor. This is followed by chemotherapy treatment.

Keywords: Treatment; Germ cell tumor; Testicular tumor.

RESUMEN

El tumor testicular se forma en uno o varios testículos. Es más común en hombres jóvenes o de edad mediana. La mayoría de los tumores testiculares comienzan a formarse en las células germinativas (que se convierten en espermatozoides) y se llaman tumor de células germinativas de testículo. La aparición de tumores de células germinativas de testículo constituye más del 90% de estos cánceres, por lo cual se decidió reportar el caso de un paciente joven con tumor testicular, diagnosticado en el Hospital Provincial Saturnino Lora, Santiago de Cuba, en 2022, con el objetivo de describirlo, para ello se consultaron 15 referencias bibliográficas. La favorable respuesta al tratamiento oncoespecífico de estos tumores y su aparición en etapas tempranas de la vida requiere un diagnóstico preciso y oportuno. El tratamiento de primera línea para el tumor testicular es la cirugía para extirpar el tumor. A esto le sigue un tratamiento de quimioterapia.

Palabras Clave:  Tratamiento; Tumor de células germinales; Tumor testicular

Received: 28/03/2024

Accepted: 26/05/2024

Published:  17/08/2024

Introduction

Since late 2019, the world has been hit by the COVID-19 pandemic, the causative agent of which is the SARS-CoV-2 coronavirus. It was first revealed at the end of this year in the city of Wuhan, China. On March 11, 2020, it was declared a pandemic by the World Health Organization (WHO) and in Cuba, the first cases from Italy were diagnosed that same day. 1

The transmission of SARS CoV-2 occurs through small microdroplets, which are emitted when speaking, sneezing or coughing. When expelled by a carrier, they pass directly to another person through inhalation or remain on objects and surfaces that then, through the hands, come into contact with the oral, nasal and ocular mucous membranes. 2

Symptoms generally begin three to seven days after the person is infected, these symptoms may include: fever, runny nose, sore throat, cough, fatigue, muscle aches, shortness of breath, expectoration, hemoptysis and diarrhea. In some people, it can occur asymptomatically. 3

In 80% of cases, it presents as a mild or moderate respiratory clinical picture, in 15% as severe and only in 5.0% as critical. As of the beginning of April 2021, 182 countries had reported positive cases for a total of 1,563,857 infected patients. In Latin America, the reported cases correspond to 34.4% of the world total, equivalent to 537,678 people. 4

In Cuba, active research efforts in Primary Health Care (PHC) contributed to controlling and reducing the catastrophes of these epidemiological events. 5

According to the Cuban Health Statistical Yearbook 2021, COVID-19 caused 8,091 deaths, for a rate of 72.3 per 100,000 inhabitants. The incidence was 954,417 cases, with a rate of 8,532.2 cases per 100,000 inhabitants. The province of Matanzas reported 76,038 cases, which represented 7.96% of the total cases. 5

Due to the health impact of COVID-19, as well as the limited dissemination of similar studies at the local level, this research was carried out with the aim of clinically and epidemiologically characterizing adult patients confirmed to have COVID-19 in a Medical Office in Matanzas.

Method

A descriptive, observational, retrospective and cross-sectional study was conducted in adult patients confirmed with COVID-19, at the Family Doctor's Office No. 46 of the "Samuel Fernández Álvarez" Polyclinic in the municipality of Matanzas, during 2021.

The universe consisted of 97 patients diagnosed with said disease during the study period. All patients aged 20 years or older with a confirmed diagnosis of COVID-19 were included. Patients with a suspected diagnosis of COVID-19 were excluded. The variables analyzed were: age in years distributed in intervals (20-29, 30-39, 40-49, 50-59, 60-69, 70-79, 80-89, ≥90. Sex: male (M) and female (F). Presence of symptoms: symptomatic and asymptomatic. Source of infection: autochthonous (if transmission occurred by people within the territory) or imported (if transmission occurred outside the territory). Diagnostic method used: PCR and Antigen Test. Personal Pathological History: Arterial Hypertension, Bronchial Asthma, Diabetes Mellitus, Ischemic Heart Disease, Obesity, Glaucoma, Hyperuricemia, others (Alzheimer's, Parkinson's, Stroke, Fibromyalgia, Osteoporosis, Osteoarthritis and Rheumatoid Arthritis). Status at discharge: cured or deceased.

Primary sources such as individual medical records and family medical records. From a statistical point of view, the data collected were processed in Excel, which allowed the storage of information and the calculation of absolute and relative percentage frequencies.

The confidentiality of the data obtained was respected. The premise was to respect the ethical principles of studies with human beings, established in the Second Declaration of Helsinki and in Cuban ethical standards. The research was approved by the Management of the Samuel Fernández Polyclinic.

Results

Table 1 shows a greater predominance of the male sex with 57 for 58.76%. The age range with the highest incidence was between 30-39 years with 24 for 24.74%; and likewise, the most affected sex in this group was the male with 15.46%.

Table 1: Distribution by age and sex of adults diagnosed with Covid-19 in the Family Medical Office No. 46 of the “Samuel Fernández Álvarez” Polyclinic in the municipality of Matanzas, during 2021

Source: Family and individual medical records.

Table 2 shows a higher rate of infection in male patients with 57 for 58.76%. The autochthonous source of infection predominated with 93 cases, which represents 95.87%.

Table 2: Distribution according to source of infection and sex

Source: Family and individual medical records.

In Table 3, symptomatic patients predominated with 59 for 60.82%, where 31.85% were male. The Antigen Test was the most useful diagnostic method applied to 51 of the cases, which represents 52.58%.

Table 3: Distribution according to symptoms, sex and diagnostic method used

Source: Family and individual medical records.

In Table 4, hypertensive patients predominated with 54 for 55.67%.

Table 4: Distribution according to Personal Pathological History

Source: Family and individual medical records.

In Table 5, 96.91% represented the rate of cured patients, while 3 patients died for 3.09%.

Table 5: Distribution according to the status of patients at medical discharge

Source: Family and individual medical records.

Discussion

At a global level during 2021, there was variability in the notification of each of the cases detected with Covid-19, where there was a greater predominance of the male sex. In the investigations carried out by Ruiz Cantero et al., 6, Chen Nanshan et al., 7, Escobar et al., 8 the male sex prevailed. Authors such as Hernández Pupo, et al 9, Llaro et al 10, Narro 11 in their articles show a predominance of the male sex and patients with ages between 19-40 years, 60-79 years and 70-75 years, respectively.

For their part, research carried out by Carbajales León et al., 12, Hernández Velázquez et al., 13, Ferrer Castro et al., 14, showed a predominance of the female sex and patients with ages equal to or greater than 60 years, which differ from the study presented.

There are several reports that justify the lower female susceptibility to contagion; Since the beginning of the pandemic, the possible female resistance to the virus has been discussed. It is thought that the low susceptibility of women to viral infections may be due to the protection of the extra X chromosome that they have compared to men. 15

In the works presented by Hernández Velázquez et al., 13 and Cuello Carballo et al., (16) a higher rate of asymptomatic patients is shown with 100 and 85.7% and with an autochthonous source of transmission for 46.66 and 38.5%. On the other hand, in the works of Medina Fuentes et al., 17 and Estrada García et al., 18 the majority of cases were imported, which does not coincide with the results of the study presented.

Various studies agree that the most frequent comorbidity in patients positive for COVID-19 is arterial hypertension, this may be due to the fact that it is one of the diseases with the highest incidence rate in the Cuban population.

This is shown by Cobas Planchez et al., 19 and Medina Fuentes et al., 17 in their articles where 36.7 and 53.8% of patients presented arterial hypertension as the most frequent comorbidity, data that coincide with the study carried out.

The authors declare as a limitation of the study that more aspects or other data of interest could not be provided because the clinical histories and family records were mostly out of date and only showed each of the data presented in the research.

Conclusions

Covid-19 largely affected, through autochthonous transmission, male adults over 30 years of age who also presented symptoms associated with the disease, which were diagnosed with the Antigen Test.

Bibliographic References

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Declaration of Conflict of Interest

The authors declare that there are no conflicts of interest.

Declaration of Financing

The authors did not receive funding for this research.

Declaration of Authorship

Conceptualization: Yonathan Estrada Rodríguez, Shania Naranjo Lima, Karen Oviedo Pérez, Carlos Luis Vinageras Hidalgo, José Fernando Placeres Hernández, Katherine Navarro Mantilla.

Data Curation: Yonathan Estrada Rodríguez, Shania Naranjo Lima.

Formal Analysis: Yonathan Estrada Rodríguez, Shania Naranjo Lima, Karen Oviedo Pérez, Carlos Luis Vinageras Hidalgo, José Fernando Placeres Hernández, Katherine Navarro Mantilla.

Investigation: Yonathan Estrada Rodríguez, Shania Naranjo Lima, Karen Oviedo Pérez, Carlos Luis Vinageras Hidalgo, José Fernando Placeres Hernández, Katherine Navarro Mantilla.

Methodology: Yonathan Estrada Rodríguez, Shania Naranjo Lima, Karen Oviedo Pérez, Carlos Luis Vinageras Hidalgo, José Fernando Placeres Hernández, Katherine Navarro Mantilla.

Supervision: Yonathan Estrada Rodríguez, Shania Naranjo Lima, Karen Oviedo Pérez, Carlos Luis Vinageras Hidalgo, José Fernando Placeres Hernández, Katherine Navarro Mantilla.

Validation: Yonathan Estrada Rodríguez, Shania Naranjo Lima, Karen Oviedo Pérez, Carlos Luis Vinageras Hidalgo, José Fernando Placeres Hernández, Katherine Navarro Mantilla.

Visualization: Yonathan Estrada Rodríguez, Shania Naranjo Lima, Karen Oviedo Pérez, Carlos Luis Vinageras Hidalgo, José Fernando Placeres Hernández, Katherine Navarro Mantilla.

Writing - original draft: Yonathan Estrada Rodríguez, Shania Naranjo Lima, Karen Oviedo Pérez, Carlos Luis Vinageras Hidalgo, José Fernando Placeres Hernández, Katherine Navarro Mantilla.

Writing - review and editing: Yonathan Estrada Rodríguez, Shania Naranjo Lima.