Objective COVID-19 progression to severe or critical illness may be related to initial clinical presentation. Main objective was to identify initial symptoms related to highest risk of disease progression, in mild or moderate suspected or confirmed COVID-19 patients or in asymptomatic subjects in contact with a recently diagnosed patient. Design and methods Historic cohort study of Mexican patients with suspected or confirmed mild or moderate COVID-19 or asymptomatic subjects in recent contact with positive patients. They sought medical attention in Centro Medico ABC or claimed for remote attention, and daily telemedicine follow up until recovery or illness progression, from April 17th to October 08th 2020. Data excerpted for analysis were sex, age, body mass index, comorbidities, and signs, and symptoms presented in first day of disease manifestations and during follow up. We used logistic regression to identify initial symptoms associated with progression disease and through a conjunctive consolidation analysis a symptom index was created. Results 120 of 1635 patients (7.2%) had clinical progression disease. By logistic regression we found as initial symptoms related to progression: fever OR 3 (1.89-4.77, p<0.001), cough OR 2.34 (1.56-3.52, p<0.001), myalgias or arthralgias OR 1.69 (1.09-2.63, p=0.018), and fatigue OR 1.65 (1.08-2.53, p=0.019). Conjunctive consolidation was processed with the previous symptoms, and a 3 groups score resulted C-19PAIS Index: 1) Fever with cough or fever with fatigue, with a probability of progression disease of 29% (31/106 patients), 2) Fever or cough or fatigue or cough with fatigue, 10.7% (66/615 patients) and 3) No fever, no cough, no fatigue, 2% (23/914). Conclusions Initial symptoms predict clinical progression in COVID-19 patients.

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Quantose MR -Resistencia a la insulina es un nuevo análisis metabolómico que consiste en una sola toma de muestra sanguínea para evaluar resistencia a la insulina. Objetivo: analizar la fiabilidad de Quantose MR -Resistencia a la insulina (Quantose MR -RI) para el diagnóstico de prediabetes en pacientes del primer nivel de atención y compararla con HOMA-IR (Homeostatic Model Assessment-Insulin Resistance), hemoglobina glucosilada y glucosa de ayuno. Material y métodos: estudio observacional, transversal-analítico, llevado a cabo en las Clínicas de Salud Incluyente y Educación, Centro Médico ABC, México. Se estudiaron 135 pacientes, edad promedio de 46 años, 77% mujeres, índice de masa corporal promedio de 30.7, con diagnóstico de prediabetes de acuerdo

Introduction: New metabolomic biomarkers as Quantose™ IR and anthropometric measurements using bioelectrical impedance analysis (BIA) provide relevant information on patients with insulin resistance and prediabetes. QuantoseTM IR is a novel metabolomic test to assess insulin resistance for screening and monitoring. Establishing a correlation between these variables is useful in clinical practice and, to our knowledge, there are no published studies that explore the relationship between Quantose™ IR and anthropometric measurements using BIA in patients with prediabetes. Objective: To evaluate the correlation between Quantose™ IR and BIA anthropometric variables (fat mass, FM; fat mass index, FMI; and body mass index, BMI) in Mexican patients with prediabetes, overweight, and obesity. Materials and Methods: This is an observational, transversal analytic study in 135 patients of both genders between 20 and 65 years of age, BMI 25.0–34.9, with diagnosis of prediabetes. The Quantose™ IR test was performed as well as anthropometric measurements (FM, FMI, and BMI) using BIA taken with Inbody 230TM. Pearson’s correlations and independent sample t-tests were estimated with a significance level of p < 0.05. Results: 135 patients were studied; 77% were female, aged 46 years in average. The prevalence of insulin resistance by Quantose™ IR was 71.1%. A positive correlation was confirmed between Quantose™ IR and FM, FMI, and BMI (p < 0.05). Patients with altered Quantose™ IR had higher FM, FMI, and BMI (p < 0.05). Conclusion: The data here presented confirm the existence of a positive and statistically significant correlation between Quantose™ IR and anthropometric measurements using BIA. This information may be useful for diagnosis and treatment in prediabetic, overweight, and obese patients.

indicadores clínicos en pacientes con prediabetes o Diabetes Mellitus tipo 2 por medio de un programa educativo. Aten Fam. 2016;23(3):89-94. atEn fam 2016;23(3) 90 Summary Objective: to evaluate the effects of a structured program of education in prediabetes (pre-d) and Diabetes Mellitus type 2 (dm2), given at the Primary Care level.Methods: quasi-experimental study, before-after, 98 patients of both sexes without social security, 20 years old or older, diagnosed with pre-d or dm2. Hemoglobin glycosylated (HbA1c), body weight and bmi were evaluated prior and after the 12 educational sessions. The Student-t test was used for dependent samples. Results: the pre-d group was formed by 27 patients and the dm2 by 71 patients. After the educational program, in patients with pre-d the HbA1c decreased in 0.30% (p=0.073) and 1.05% (p=0.000) in those with dm2; in the first group there was a loss of body weight of 870 g (p=0.010) and the second, 820 g (p = 0.016). Conclusions: learning about pre-d and dm2 can promote positive changes in self-care and medical treatment for the patient.