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Background There is no strong evidence that any drug is beneficial either for the treatment of SARS-CoV-2 disease or for post-exposure prophylaxis. Therefore, clinical research is crucial to generate results and evaluate strategies against COVID-19. Primary care (PC) centers, the first level of care in the health system, are in a favorable position to carry out clinical trials (CD), as they work with a large volume of patients with varied profiles (from acute to chronic pathologies). During the COVID-19 pandemic, the need for hospital admission and mortality is higher in people > 60 years. Therefore, this is a target population to try to reduce the serious complications and lethality of COVID pneumonia and to avoid overloading the hospital system. Given the pharmacological properties of colchicine (anti-inflammatory and anti-fibrotic, possible inhibition of viral replication, and inhibitory effect on coagulation activation), early treatment with colchicine may reduce the rate of death and serious pulmonary complications from COVID-19 in vulnerable patients. Methods The COLCHICOVID study is a randomized, multicenter, controlled, open-label parallel group (2:1 ratio), phase III clinical trial to investigate the efficacy of early administration of colchicine in reducing the development of severe pulmonary complications associated with COVID-19 infection in patients over 60 years of age with at-risk comorbidities. Discussion This is a pragmatic clinical trial, adapted to usual clinical practice. The demonstration that early administration of colchicine has clinical effectiveness in reducing the complications of SARS-CoV-2 infection in a population highly susceptible may mitigate the health crisis and prevent the collapse of the health system in the successive waves of the coronavirus pandemic. In addition, colchicine is a well-known medicine, simple to use in the primary care setting and with a low cost for the health system. Trial registration ClinicalTrials.govNCT04416334. Registered on 4 June 2020. Protocol version: v 3.0, dated 22 September 2020.

Objective: Hospital admissions in COPD patients, represent a health care overload and an economic burden as well as they worsen the patient prognosis. Our objective was to describe the prevalence of these events in a ‘real life’ cohort of two years of follow-up. Methods: Retrospective population-based cohort study. 1792 COPD patients were selected by simple random sampling from all COPD patients in Cantabria (Northern Spain). Severe exacerbations (hospitalization due to COPD exacerbation) were computed during each year of follow up, as well as admissions for another cause. Results: There were 343 severe exacerbations, belonging to 228 patients. In other words, only 12.7% of patients had at least one admission per COPD exacerbation in the first follow-up year. Most of these patients had only one (162/228, 71.1%) or two admissions (43/228, 18.9%), although the remaining 23 patients (10.1%) accumulated a total of 95 admissions (27.7%) with a range of 3 to 8 admissions per patient. The next year 362 admissions were recorded and 34 patients (15.5% of severe exacerbations) accumulated 35.9% (130/362) of admissions, ranging from 3 to 7 admissions per patient. Regarding admissions for another cause, there were 240 belonging to 176 patients, so 9.8% of patients had at least one admission for other reasons during the first year. The next year, this % increased to 13.8%. The range of admissions for other causes was from 1 to 7 and again less than 10% of patients accumulated more than 20% of these admissions. Conclusions: Our data suggest that less than 15% of patients have hospital admissions. However, there is a patient profile that tends to accumulate re-admissions, requiring political-health interventions in this sense.

Objective: Several studies support that the risk of asthma exacerbations (AE) is higher in women than in men. We analyze whether this association can be explained by confounding due to variables such as obesity or older age. Methods: Retrospective population-based cohort study including 2000 asthmatic adult patients obtained by simple-random-sampling. AE requiring oral corticosteroid were considered as ‘moderate’, and AE requiring ‘parenteral corticosteroid and/or magnesium sulphate’ were considered as ‘severe’. Adjusted Odds Ratios (OR) and their 95% confidence intervals (95%CI) were estimated by logistic regression. Results: The overall mean age was 41.7 years [SD=19.7], with 46.2 % of men and 53.8 % of women. Women had a higher risk of suffering at least one moderate exacerbation the follow-up year: OR 2.01; 95%CI (1.42 to 2.85). Both obesity: OR 2.40; 95%CI (1.51 to 3.81) and age: OR (increase per decade) 1.31; 95%CI (.1.21 to 1.41) were associated with a higher risk of AE, meeting the criteria to be treated as confounding variables. After including age as a confounding variable, the association between being female and the risk of AE did not change substantially: OR 1.56; 95%CI (1.09 to 2.25). After including obesity (BMI) association also remained: OR 1.73; 95%CI (1.16 to 2.57). However, after including both obesity and age together in the same multivariable model, the association between being female and the risk of AE diminished and lost statistical significance: OR 1.44; 95% CI (0.95 to 2.17). Conclusions: Female gender is associated with an increased risk of AE. However, this association can be explained by women’s older age and obesity, acting both as confounders.

Objective: To determine the comorbidities associated to a poor control of asthma. Methods: Retrospective population-based cohort study including 2000 asthmatic patients obtained by simple-random-sampling. Asthma exacerbations were defined as episodes requiring at least oral corticosteroid. The excessive use of rescue medication was determined by the ‘asthma medication ratio’, being the ratio Results: 7.9% of patients suffered from at least one moderate exacerbation during the monitoring year. The 15.1% of the patients scored Conclusions: Psychiatric history, cardiovascular disease and chronic renal failure were independently associated to a worse control of asthma. The association for chronic renal failure was especially strong and deserve further consideration.