• Héctor Raúl Vargas-Sánchez, Juan Carlos Tomás-López, Verónica Álvarez-Medina, Luisa Estela Gil-Velázquez, Hortensia Vega-Vega, Alejandro Alarcón-López, Rafael Pérez-Villegas, Claudia María Carbajal-García, Eugenia Del Rocío Rivera-Tello, Manuel Cervantes-Ocampo, Célida Duque-Molina, and Iván de Jesús Ascencio-Montiel.
• From División de Medicina Familiar, Instituto Mexicano del Seguro Social, Mexico City, Mexico; Hospital de Ginecoobstetricia con Medicina Familiar 60, Instituto Mexicano del Seguro Social, Mexico City, Mexico; Coordinación de Atención Integral a la Salud en el Primer Nivel de Atención, Instituto Mexicano del Seguro Social, Mexico City, Mexico; Dirección de Prestaciones Médicas, Instituto Mexicano del Seguro Social, Mexico City, Mexico; and Coordinación de Vigilancia Epidemiológica, Instituto Mexicano del Seguro Social, Mexico City, Mexico.
• J Am Board Fam Med. 2023 Feb 8; 36 (1): 164169164-169.

BackgroundPrimary care level close monitoring of mild COVID-19 patients has shown to provide a risk reduction in hospitalization and death. We aimed to compare the risk of all-cause death among COVID-19 ambulatory patients who received and did not receive telephonic follow-up in primary health care settings.MethodsA secondary database analysis, 2-group comparative study, was conducted with data from the medical information systems of the Mexican Institute of Social Security. A total of 1,498,808 ambulatory patients aged 20 years old and over and with laboratory confirmed SARS-CoV-2 by PCR or rapid antigen test were analyzed. Of them, 535,898 (35.8%) where followed by telephonic calls. The cases were attended from October 14, 2020, to April 10, 2022. Death incidence was evaluated. To assess the association between death and telephonic follow-up we calculated risk ratio using a multivariate logistic model.ResultsCase fatality rate was 1.29% in the patients who received telephonic follow-up and 2.95% in the cases who did not receive phone calls. Medical history of chronic kidney disease, COPD, cardiovascular disease, tobacco consumption and diabetes were associated with increased risk of death. In the multivariate model, telephonic follow-up was associated with lower risk of all-cause death, with an adjusted risk ratio of 0.61 (95% confidence interval from 0.59, 0.64).ConclusionOur data suggest that telephonic follow-up is associated with a risk of death reduction in adult outpatients with mild COVID-19, in the context of a multimodal strategy in the primary health care settings.© Copyright by the American Board of Family Medicine.

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