Percorrer por autor "Costa, Andreia"
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- Long-term cardiovascular events in individuals hospitalised with COVID-19: a retrospective cohortPublication . Soares, Patricia; Ruivinho, Carolina; Silva, Joana; Lobão, Maria João; Santos, Lelita; Paixão, Joana; Ramalho, Ana Rita; Henriques, Adriana; Simões, Inês; Guimarães, Luísa Eça; Moça, Rita; Costa, Andreia; Atanásio, Gabriel; Nóbrega, Sofia; Brazão, Maria da Luz; Goes, Ana Rita; Leite, Andreia; LOCUS groupBackground: Post-COVID condition encompasses a spectrum of persistent or emerging symptoms affecting multiple organ systems, including a heightened risk of cardiovascular complications. Despite growing recognition of this phenomenon, there remains a lack of comprehensive data regarding the incidence and risk factors associated with cardiovascular events during the post-acute phase in patients previously hospitalised for COVID-19. Thus, we aimed to estimate the incidence of cardiovascular events among patients hospitalised for COVID-19 in Portugal and assess the association between patient and infection characteristics and cardiovascular events in the COVID-19 post-acute phase. Methods: We conducted a registry-based retrospective cohort study from seven hospitals across Portugal. Data was retrospectively collected from the electronic medical record of each patient. We included individuals hospitalised due to COVID-19 between March 2020 and March 2021. Our outcome of interest was cardiovascular events in the post-acute phase of COVID-19, occurring at least 30 days after a positive SARS-CoV-2 test. The variables of interest considered were the severity of the episode, existing cardiovascular risk and vaccination status before the SARS-CoV-2 test. Person-years was estimated for each individual, and incidence rates were estimated. A Cox proportional hazard regression model was employed to assess risk factors. Results: We included 1,803 patients in the analysis, of which 143 (7.9%) experienced at least one cardiovascular event following COVID-19 hospitalisation. The overall incidence rate of having at least one cardiovascular event was 34.65 per 1,000 person-years (95% confidence interval (CI): 29.20; 40.82). We found higher risk of cardiovascular events for individuals with pre-existing cardiovascular risk (adjusted hazard ratio (aHR): 3.76, 95% CI: 1.53; 9.24) and lower risk for individuals with at least one vaccine dose before the SARS-CoV-2 test (partial vaccination - aHR: 0.44, 95%CI: 0.30; 0.64, complete vaccination - aHR: 0.46, 95%CI: 0.2; 0.80). We did not find a significant difference between the severity of the COVID-19 episode and the risk of having cardiovascular events post-COVID-19. Conclusion: Our findings suggest a substantial burden of cardiovascular complications post-COVID-19, underscoring the need for health services to be prepared and commence screening and preventive measures for individuals at higher risk.
- Perceptions of Fall Prevention and Engagement in Social Prescribing Activities Among Older Adults: A Cross-Sectional Study in PortugalPublication . Matos, Cristiano; Baixinho, Cristina Rosa; Alarcão, Violeta; Henriques, Maria Adriana; Ferreira, Ricardo Oliveira; Nascimento, Tiago; Arriaga, Miguel; JORGE SILVA ALVES, TATIANA DANIELA; Nogueira, Paulo; Costa, AndreiaBackground: Falls are a major cause of injury, functional decline, and reduced quality of life among older adults, posing a significant public health challenge. Social prescribing is gaining relevance in gerontology, offering structured strategies to engage individuals in preventive activities, including fall prevention strategies, through engagement in community-based activities. Aim: To examine older adults' perception of the relevance of personal protection and development activities (e.g., prevention against falling) and compare sociodemographic, behavioural, and engagement profiles between those who agree and those who disagree with its relevance. Methods: A cross-sectional study was conducted with 613 older adults aged 65-93 years. Data collection included sociodemographic, health-related, and behavioural/social engagement variables (including perceptions regarding the benefits of social prescribing and interest in community-based activities). For this analysis, participants were dichotomized based on their agreement with the relevance of personal protection and development activities (e.g., prevention against falling). Of the 569 participants included, 538 (94.5%) agreed with its relevance and 31 (5.5%) disagreed. Descriptive and exploratory analyses were conducted to compare the two groups across variables. Multivariate logistic regression analyses were conducted to explore independent predictors of agreement across sociodemographic, behavioural, social prescribing, and health-related variables. Results: Significant differences were observed between the groups in awareness of active ageing (p = 0.018), volunteering (p < 0.001), participation in social and community activities (p < 0.001), and hobbies like gardening, fishing, or cooking (p = 0.002). Those who agreed with the importance of personal protection and development activities were significantly more likely to value a range of initiatives, including social activities in recreational organizations, physical activity in the community (e.g., hiking), artistic and creative activities (e.g., visual arts, music), technical or technological activities (e.g., do-it-yourself, computers), and cultural enrichment activities (e.g., visiting museums), (p < 0.001). Multivariate analyses showed no effects of sociodemographic or health-related factors, whereas behavioural and engagement-related variables-including volunteering, hobbies, and several social prescribing activities-significantly predicted agreement with the relevance of personal protection and development activities. Discussion: The findings suggest that older adults who perceive fall prevention as relevant are more actively engaged in diverse health-promoting activities, including volunteering, hobbies, and community-based programmes. This pattern may reflect higher health literacy, stronger social networks, and proactive attitudes towards ageing. Conclusions: Perceptions of fall prevention are closely linked to broader patterns of engagement in health-promoting activities among older adults. Recognizing and addressing differences in how these activities are valued can inform more inclusive and targeted gerontological interventions.
- The Role of Health Preconditions on COVID-19 Deaths in Portugal: Evidence from Surveillance Data of the First 20293 Infection CasesPublication . Nogueira, Paulo Jorge; de Araújo Nobre, Miguel; Costa, Andreia; Ribeiro, Ruy M.; Furtado, Cristina; Bacelar Nicolau, Leonor; Camarinha, Catarina; Luís, Márcia; Abrantes, Ricardo; Vaz Carneiro, AntónioBackground: It is essential to study the effect of potential co-factors on the risk of death in patients infected by COVID-19. The identification of risk factors is important to allow more efficient public health and health services strategic interventions with a significant impact on deaths by COVID-19. This study aimed to identify factors associated with COVID-19 deaths in Portugal. Methods: A national dataset with the first 20,293 patients infected with COVID-19 between 1 January and 21 April 2020 was analyzed. The primary outcome measure was mortality by COVID-19, measured (registered and confirmed) by Medical Doctors serving as health delegates on the daily death registry. A logistic regression model using a generalized linear model was used for estimating Odds Ratio (OR) with 95% confidence intervals (95% CI) for each potential risk indicator. Results: A total of 502 infected patients died of COVID-19. The risk factors for increased odds of death by COVID-19 were: sex (male: OR = 1.47, ref = female), age ((56-60) years, OR = 6.01; (61-65) years, OR = 10.5; (66-70) years, OR = 20.4; (71-75) years, OR = 34; (76-80) years, OR = 50.9; (81-85) years, OR = 70.7; (86-90) years, OR = 83.2; (91-95) years, OR = 91.8; (96-104) years, OR = 140.2, ref = (0-55)), Cardiac disease (OR = 2.86), Kidney disorder (OR = 2.95), and Neuromuscular disorder (OR = 1.58), while condition (None (absence of precondition); OR = 0.49) was associated with a reduced chance of dying after adjusting for other variables of interest. Conclusions: Besides age and sex, preconditions justify the risk difference in mortality by COVID-19.
