[Epidemiological and clinical characteristics of the COVID-19 epidemic in Mexico: Quintana Roo case]. / Características epidemiológicas y clínicas de la epidemia COVID-19 en México: caso Quintana Roo.

Objective: Identify risk factors for severe outcome in Mexican patients with COVID-19 in the population of Quintana Roo. Material and methods: Study of 5,916 who met the criteria for suspected cases of COVID-19, 2,531 confirmed by qrTPCR-Sars-CoV-2 tests, of which 1,486 were positive, among which they were classified as hospitalized (severe COVID-19) and outpatients. Multivariate logistic regression analysis was performed to explore the factors associated with the severity of COVID-19 and death as clinical outcomes. The basic reproduction number (R0) was calculated Statistical analysis) Endorsement of the ethics committee 2301. Results: SARS-CoV-2 positive patients presented a high prevalence of hypertension 29.1%, diabetes 23.5%, obesity 24%, and 48.5% have at least one chronic disease. There is a high risk of severity for COVID-19 in patients with diabetes OR=3.14, hypertension OR=1.88, obesity OR=1.68, kidney disease OR=3.2, older than 65 years OR=13.6 and men OR=1.7. These factors also increase the risk of death up to 7.7 times. The maximum R0 during the epidemic was 2.4. Conclusion: Liver and kidney disease, diabetes, hypertension, and obesity are significantly associated with severe COVID-19 and death.

Objetivo: identificar factores de riesgo para desenlace a COVID-19 grave en pacientes mexicanos con de COVID-19 en población en Quintana Roo. Material y métodos: estudio de 5,916 quienes cumplieron criterios de casos sospechosos de COVID-19, 2,531 confirmados por pruebas qrTPCR-Sars-CoV-2 de los cuales 1,486 fueron positivos entre los cuales se clasifico en hosptializados (COVID-19 grave) y ambulatorios. Se realizó análisis de regresión logística multivariada para explorar los factores asociados con la gravedad de COVID-19 y defunción como desenlaces clínicos. Se calculó el número básico de reproducción (R0) Análisis estadístico) Aval del comité de ética 2301. Resultados: pacientes positivos a SARS-CoV-2 presentaron alta prevalencia de hipertensión 29.1%, diabetes 23.5%, obesidad 24%, y 48.5% tiene al menos una enfermedad crónica. Existe alto riesgo de severidad para COVID-19 en pacientes con diabetes OR=3.14; hipertensión OR=1.88, obesidad OR=1.68, enfermedad renal OR=3.2, mayores de 65 años OR=13.6 y hombres OR=1.7. Estos factores también incrementan el riesgo de defunción hasta 7.7 veces. El R0 máximo durante la epidemia fue de 2.4. Conclusión: la enfermedad hepática, renal, diabetes, hipertensión y obesidad se asocian significativamente a COVID-19 severo y defunción.

Laboratory-confirmed SARS-CoV-2 reinfection in the population treated at social security.

The scientific community has questioned whether reinfection with SARS-CoV-2 is possible. Gradually, cases of reinfection have been documented. In Mexico, people with SARS-CoV-2 reinfection have not been officially identified. To allow a retrospective investigation of patients with PCR-confirmed SARS-CoV-2 and to identify how reinfected with this virus occurs in a population that requires medical attention. A retrospective search of the epidemiological surveillance system was performed to identify people who met the clinical criteria based on laboratory diagnosis of SARS-CoV-2 and temporality to identify cases of reinfection. Clinical information was collected from clinical records. Seven people with two separate COVID-19 events were identified in medical units in Quintana Roo, Mexico between April and December 2020. The overall median interval between the two events was 156 days (61-191 days). Six people were health workers, and one was a member of the general population. This is one of the first reports of reinfection in health personnel in Mexico, revealing that the frequency of reinfection is low among positive cases and that the interval between infection episodes was three months. There are several scenarios in the natural history of the disease that must be considered based on adequate anamnesis with a clinical-epidemiological approach to determine the correct diagnostic category.