Sanid. mil. 2020; 76 (2) 51
Sanidad Militar
Revista de Sanidad de las Fuerzas Armadas de España
Sanid. mil. Volumen 76, número 2. ISSN: 1887-8571 Abril-junio 2020
CONTENTS
EDITORIAL
55 Military Health in the face of the COVID-19 breakdown
Conde-Ortiz A.R.
ORIGINAL ARTICLE
57 Lessons identified by the Hyperbaric Departament about the treatment for COVID-19 patients with hyperbaric oxygentherapy
Callejón-Peláez E.G., Baragaño-Ordóñez M.E., Martínez-Izquierdo A., Viqueira-Caamaño A., Pujante-Escudero A.
SUMMARY: Introduction: During the first period of the COVID-19 pandemic and due to saturation of the health care system,
it was necessary to treat with hyperbaric oxygen therapy (HBO) (in the Hyperbaric Medicine Service at the Defence Central
Hospital «Gómez Ulla» (HCD)), some patients with PCR (+) for COVID -19, or with clinical, radiological or analytical high
indicative data. Objectives: to treat patients without positive answer to regular treatment and to check the effectiveness of HBO
as useful therapy for COVID-19. Material and method: There were valued 11 requests for treatment from COVID-9 wards and
the Intensive Care Department. Eventually 6 of those patients were treated. These patients were treated in a multiplace hy-perbaric
chamber between 1.6 and 2 ATAs and for 90 to 105 minutes of time, with ancillary personnel inside the chamber the
whole sessions. There were also developed security protocols to prevent COVID-19 infection. Image and analytics controls were
followed. Results and conclusions: 35 sessions of treatment were completed. The patients received from 1 to 14 sessions. It did
not happen any case of infection on the medical personnel of the HBO Department. The patients which (due to their physical
status) could receive 5 or more sessions had a better clinical evolution. Some desaturation reflexes were observed.
KEY WORDS: COVID-19, HCD, hyperbaric oxygen therapy (OHB) and hyperbaric chamber.
64 Mortality in the first four months of 2020 in the COVID-19 pandemic. Analysis of the Mortality Committee of the Hospital
Central de la Defensa «Gómez Ulla», Madrid
Sáez-García MA., García-Anaya MP., Sánchez-González B., Fernández-Pascual C., Gracia-Martínez M., Marqueta-García
O., Yuste-del-Pozo V. , Ferrara-Coppola C.
SUMMARY: Introduction: In December 2019, Wuhan, China had an outbreak of the COVID-19 disease, caused by the severe
acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The disease quickly turned into a pandemic. The risk factors asso-ciated
with its mortality are yet to be determined. The Mortality Committee studies hospital deaths with the main objective
of reducing preventable deaths. Objectives: To describe the comorbidity and demographic characteristics of the deaths from
the first four-month period of 2020 at the Central Defense Hospital and their relationship with COVID-19. Material and
methods: Cross-sectional, descriptive, observational and retrospective study. Clinical and demographic data of deaths in rela-tion
to the presence of COVID-19. Results: Of 371 deceased, 271 positive COVID-19 and 100 negative COVID-19-. Almost
1.8 times more than the expected mortality in the four-month period (208 to 371). Average age of the groups 80 and 84 years,
range between 35 and 104 years. Hospital stay at positive COVID-19 10.1% compared to 5.5% at negative COVID-19. Foreign
exitus under 70 years 80%. Exit location: hospital plant (84%). Average Charlson index score: 4 points (interquartile, 2-6),
53% estimated survival at 10 years. Most frequent comorbidities: HTN (70.5%); DM (36.5%); Oncological (31%); Pneumonia
(86.7%). Poor general condition at admission (81.9%). Conclusions: The variable with the greatest power related to mortality
was advanced age. Another group, without comorbidities, younger than 51 years, presented fatal evolution. Despite the diffi-culty
in establishing the actual mortality rate from COVID-19, the difference between the expected deaths and those recorded
by the Hospital Mortality Committee constitutes the most approximate value.
KEYWORDS: COVID-19, Coronavirus, Comorbidity, Mortality Committee, Madrid.
SHORT COMMUNICATION
71 Acute arterial ischemia in patients with COVID 19 infection
Sainz-González F., Martínez-Izquierdo A, Abdelkader-Abu-Sneimeh A.
SUMMARY: The infection caused by the novel coronavirus SARS-COV-2 (COVID-19) which was declared global pandemic
by the WHO has showed to be a highly thrombotic disease in some patients, presenting with venous and arterial complications
such as deep vein thrombosis, pulmonary embolism and acute ischemia affecting patients with and without previous diseases.
We describe four cases of COVID-19 patients treated in Gomez Ulla Hospital of Madrid during the pandemic. Clinical man-ifestations
and outcome are compared with other similar series.
KEY WORDS: Coronavirus COVID-19. hypercoagulable states. Acute arterial ischemia and exacerbated chronic ischemia.
REPORTS
74 The Spanish Central Defense Hospital in COVID-19 Crisis
Sáez-Garrido J.D., Tafalla-García J.J., Chacartegui-Quetglas M.
SUMMARY: In this paper, we present the changes made at the Central Defense Hospital «Gomez Ulla» to face the COVID-19
crisis. A description on the available capabilities prior to the pandemic outbreak is made, and how they had to adapt to a