RESUMO
Background: The COVID-19 pandemic poses a significant global health threat, characterized by high morbidity, severity, and the emergence of concerning variants. Latin America has been greatly affected, with high infection and mortality rates. Vaccination plays a crucial role in mitigating severe disease and controlling the pandemic. This study aims to assess the effectiveness of COVID-19 vaccines in preventing SARS-CoV-2 severe acute respiratory infections (SARI) in hospitalized vaccination target groups in Ecuador. Methods: This is a test-negative design study. We used data reported through sentinel surveillance of SARI between May 2021 and March 2022 in Ecuador. Patients with case criteria of SARI and hospitalized for a minimum of 24 hours were included in the study. Cases were defined as patients with SARI with a positive RT-qPCR test for SARS-CoV-2 and controls were those with a negative result. Information on vaccination status was obtained from the national vaccination registry, a valid dose of vaccination was considered when it was administered at least 14 days prior to symptom onset. Vaccine effectiveness (VE) (1-OR/OR) was calculated using a logistic regression. Results: A total of 1,277 patients were included in the analysis of VE. The adjusted vaccine effectiveness (aVE) in preventing hospitalization, adjusted for sex, age group, presence of one or more comorbidities, and period of the predominance of the omicron variant, was 44.5% for the partial primary schedule, 74.7% for the complete primary schedule, and 79.9% for the complete primary schedule plus booster doses. The aVE in avoiding ICU admissions was close to 80% with both the complete primary schedule and the booster doses, and in avoiding deaths, the aVE was 89% and 98%, respectively. Conclusions: In Ecuador, COVID-19 vaccination prevents hospitalizations, ICU admissions, and deaths. The effectiveness of the vaccines improves with more doses, offering increased protection across all age groups.
RESUMO
Estudiamos las características de 42 mujeres y 15 hombres con diagnóstico de enfermedad bipolar(edad promedio: 48 años). La enfermedad se inicia como promedio a los 29 años. No encontramos correlación entre edad de inicio y latencia en el diagnóstico, que es de 12 años en promedio. La latencia es mucho más alta en las décadas anteriores y tiende a desaparecer en los años 90, tal vez por el mayor grado de información sobre los trastornos del ánimo. El error diagnóstico inicial más frecuente fue esquizofrenia: 48 por ciento de los casos; en tanto que el diagnóstico correcto de trastorno bipolar se planteó desde el comienzo de la enfermedad sólo en el 28 por ciento. El 11 por ciento de los casos presenta hipotiroidismo. En 29 de los 57 pacientes existen antecedentes genéticos de enfermedad bipolar, y es mucho más frecuente en la familia materna que en la paterna