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1.
Gac Med Mex ; 157(3): 263-270, 2021.
Article in English | MEDLINE | ID: covidwho-1535083

ABSTRACT

INTRODUCTION: Historically, pandemics have resulted in higher mortality rates in the most vulnerable populations. Social determinants of health (SDH) have been associated with people morbidity and mortality at different levels. OBJECTIVE: To determine the relationship between SDH and COVID-19 severity and mortality. METHODS: Retrospective study, where data from patients with COVID-19 were collected at a public hospital in Chile. Sociodemographic variables related to structural SDH were classified according to the following categories: gender, age (< 65 years, ≥ 65 years), secondary education (completed or not), work status (active, inactive) and income (< USD 320, ≥ USD 320). RESULTS: A total of 1,012 laboratory-confirmed COVID-19 cases were included. Average age was 64.2 ± 17.5 years. Mortality of the entire sample was 14.5 %. Age, level of education, unemployment and income had a strong association with mortality (p < 0.001). CONCLUSIONS: The findings reinforce the idea that SDH should be considered a public health priority, which is why political efforts should focus on reducing health inequalities for future generations.


Subject(s)
COVID-19/epidemiology , Social Determinants of Health , Age Factors , Aged , Aged, 80 and over , COVID-19/mortality , COVID-19/physiopathology , Chile/epidemiology , Educational Status , Female , Hospitals, Public , Humans , Income/statistics & numerical data , Male , Middle Aged , Retrospective Studies , Risk Factors , Severity of Illness Index , Unemployment/statistics & numerical data
2.
Parasit Vectors ; 14(1): 282, 2021 May 26.
Article in English | MEDLINE | ID: covidwho-1523322

ABSTRACT

Trichinellosis is a foodborne disease caused by several Trichinella species around the world. In Chile, the domestic cycle was fairly well-studied in previous decades, but has been neglected in recent years. The aims of this study were to analyze, geographically, the incidence of trichinellosis in Chile to assess the relative risk and to analyze the incidence rate fluctuation in the last decades. Using temporal data spanning 1964-2019, as well as geographical data from 2010 to 2019, the time series of cases was analyzed with ARIMA models to explore trends and periodicity. The Dickey-Fuller test was used to study trends, and the Portmanteau test was used to study white noise in the model residuals. The Besag-York-Mollie (BYM) model was used to create Bayesian maps of the level of risk relative to that expected by the overall population. The association of the relative risk with the number of farmed swine was assessed with Spearman's correlation. The number of annual cases varied between 5 and 220 (mean: 65.13); the annual rate of reported cases varied between 0.03 and 1.9 cases per 105 inhabitants (mean: 0.53). The cases of trichinellosis in Chile showed a downward trend that has become more evident since the 1980s. No periodicities were detected via the autocorrelation function. Communes (the smallest geographical administrative subdivision) with high incidence rates and high relative risk were mostly observed in the Araucanía region. The relative risk of the commune was significantly associated with the number of farmed pigs and boar (Sus scrofa Linnaeus, 1758). The results allowed us to state that trichinellosis is not a (re)emerging disease in Chile, but the severe economic poverty rate of the Mapuche Indigenous peoples and the high number of backyard and free-ranging pigs seem to be associated with the high risk of trichinellosis in the Araucanía region.


Subject(s)
Swine Diseases/epidemiology , Trichinellosis/epidemiology , Animals , Bayes Theorem , Chile/epidemiology , Disease Outbreaks , Geographic Mapping , History, 20th Century , History, 21st Century , Incidence , Risk Assessment , Swine , Trichinella , Trichinellosis/history
3.
Front Public Health ; 9: 590335, 2021.
Article in English | MEDLINE | ID: covidwho-1477881

ABSTRACT

Objectives: This paper reviews the mental health policies that have been implemented in Chile in response to the COVID-19 pandemic and the international context of countries' responses. Even before the start of the pandemic, there were significant barriers to access mental health services in Chile, coupled with a scenario of nationwide social unrest and protests that questioned the legitimacy of public institutions; now the rapidly worsening outbreaks of COVID-19 are exacerbating the pre-existing mental health crisis. Methods: We conducted a bibliometric and content analysis of the Chilean mental health public policies implemented during the COVID-19 pandemic and then compared these policies with international experiences and emerging scientific evidence on the mental health impact of pandemics. Results: Our analysis of the policies identifies five crucial points of action developed in Chile: (i) an established framework to address mental health in emergency and disaster situations; (ii) a timely COVID-19 Mental Health Action Plan; (iii) inclusion of mental health in the public health agenda; (iv) development of a presidential strategy during the pandemic for comprehensive mental health and well-being; and (v) emerging research assessing the mental health implications of COVID-19. Conclusions: In Chile, the public policy responses to address the mental health consequences of the COVID-19 pandemic has been characterized by the coordinated implementation of mental health plans, ranging from a health sectoral initiative to inter-agency and intersectoral efforts. However, it is imperative that increased funding is allocated to mental health, and efforts should be made to promote the participation of people with lived experiences and communities in the design and implementation of the proposed actions. This aspect could be of key importance to social peace and community recovery after the pandemic.


Subject(s)
COVID-19 , Pandemics , Chile/epidemiology , Humans , Mental Health , Pandemics/prevention & control , Public Policy , SARS-CoV-2
4.
BMC Public Health ; 21(1): 1802, 2021 10 19.
Article in English | MEDLINE | ID: covidwho-1477399

ABSTRACT

BACKGROUND: During the COVID-19 pandemic, reductions in healthcare utilization are reported in different contexts. Nevertheless, studies have not explored specifically gender disparities in access to healthcare in the context of COVID-19. METHODS: To evaluate gender disparities in access to medical in Chile we conducted an interrupted time series analysis using segmented regression. The outcome variable was the number of weekly confirmed cases of a set of oncologic and cardiovascular time-sensitive conditions at a national level. The series contained data from weeks 1 to 39 for 2017 to 2020. The intervention period started at week 12. We selected this period because preventive interventions, such as school closures or teleworking, were implemented at this point. We estimated the level effect using a dummy variable indicating the intervention period and slope effect using a continuous variable from weeks 12 to 39. To test heterogeneity by gender and age group, we conducted a stratified analysis. RESULTS: We observed a sizable reduction in access to care with a slowly recovery for oncologic (level effect 0.323; 95% CI 0.291-0.359; slope effect 1.022; 95% CI 1.016-1.028) and cardiovascular diseases (level effect 0.586; 95% CI 0.564-0.609; slope effect 1.009; 95% CI 1.007-1.011). Greater reduction occurred in women compared to men, particularly marked on myocardial infarction (level effect 0.595; 95% CI 0.566-0.627 versus 0.532; 95% CI 0.502-0.564) and colorectal cancer (level effect 0.295; 95% CI 0.248-0.35 versus 0.19; 95% CI 0.159-0.228). Compared to men, a greater absolute reduction was observed in women for oncologic diseases, excluding sex-specific cancer, (1352; 95% CI 743-1961) and cardiovascular diseases (1268; 95% CI 946-1590). CONCLUSION: We confirmed a large drop in new diagnoses for time-sensitive conditions during the COVID-19 pandemic in Chile. This reduction was greater for women. Our findings should alert policy-makers about the urgent need to integrate a gender perspective into the pandemic response.


Subject(s)
COVID-19 , Myocardial Infarction , Chile/epidemiology , Female , Health Services Accessibility , Humans , Male , Pandemics , SARS-CoV-2
5.
J Urban Health ; 98(5): 622-634, 2021 10.
Article in English | MEDLINE | ID: covidwho-1474087

ABSTRACT

The Covid-19 pandemic has reached almost every corner of the world. Despite the historical development, approval, and distribution of vaccines in some countries, non-pharmaceutical interventions will remain an essential strategy to control the pandemic until a substantial proportion of the population has immunity. There is increasing evidence of the devastating social and economic effects of the pandemic, particularly on vulnerable communities. Individuals living in urban informal settlements are in a structurally disadvantaged position to cope with a health crisis such as the Covid-19 pandemic. Estimates of this impact are needed to inform and prioritize policy decisions and actions. We study employment loss in informal settlements before and during the Covid-19 pandemic in Chile, using a longitudinal panel study of households living in Chile's informal settlements before and during the health crisis. We show that before the pandemic, 75% of respondents reported being employed. There is a decrease of 30 and 40 percentage points in May and September 2020, respectively. We show that the employment loss is substantially higher for individuals in informal settlements than for the general population and has particularly affected the immigrant population. We also show that the pandemic has triggered neighborhood cooperation within the settlements and that targeted government assistance programs have reached these communities in a limited way. Our results suggest that individuals living in informal settlements are facing severe hardship as a consequence of the pandemic. In addition to providing much-needed support, this crisis presents a unique opportunity for long-term improvements in these marginalized communities.


Subject(s)
COVID-19 , Pandemics , Chile/epidemiology , Employment , Humans , SARS-CoV-2
6.
Int J Environ Res Public Health ; 18(19)2021 Oct 07.
Article in English | MEDLINE | ID: covidwho-1457652

ABSTRACT

The spatial and temporal behavior of the occurrence of forest fires in Chile was evaluated in the presence of COVID-19 and mobility restrictions. The fire period from 2015-2016 to 2020-2021 was considered and statistics on mobility restrictions were granted by the Government of Chile. The analysis was developed at different scales of geographic perception. At the national and regional levels, the global behavior of the occurrence was determined, and later at the communal level, the political territorial unit, to determine internal variations attributable to the mobility dynamics in the quarantine period. In the process, the meteorological background of the fire activity was also considered. The results indicate that it is possible to rule out a meteorological effect, based on the variation of the moisture content of fine fuel. There was also no statistical association between the humidity of the fuel and the variation in the occurrence of fires. It is concluded that the communes that presented the greatest mobility of people before the pandemic were those that obtained the greatest reduction in fires. The variation in mobility, the product of restriction measures, is a statistical predictor of the increase or decrease in fires.


Subject(s)
COVID-19 , Fires , Wildfires , Chile/epidemiology , Forests , Humans , Pandemics , SARS-CoV-2
7.
Public Health ; 198: 332-339, 2021 Sep.
Article in English | MEDLINE | ID: covidwho-1401796

ABSTRACT

OBJECTIVES: To compare food insecurity (FI) in Chile before and during the COVID-19 pandemic according to different household types and vulnerability indicators. STUDY DESIGN: Longitudinal study based on two population-based surveys in Chile (CASEN 2017 and COVID 2020). METHODS: Descriptive analysis and multinomial regression models for FI through the Food Insecurity Experience Scale (FIES). RESULTS: FI levels increased significantly (P < 0.001) between 2017 (30%) and 2020 (49%). There was increased FI in all households, but especially in those with economically dependent persons (i.e. children, adolescents and older adults). Household vulnerability indicators showed a statistically significant relationship with FI both before and during the pandemic. The pandemic has resulted in new population groups experiencing FI. CONCLUSIONS: The COVID-19 pandemic has led to a significant increase in FI, which has also been seen in new population groups.


Subject(s)
COVID-19 , Pandemics , Adolescent , Aged , Child , Chile/epidemiology , Cross-Sectional Studies , Family Characteristics , Food Insecurity , Food Supply , Humans , Longitudinal Studies , SARS-CoV-2
9.
Public Health Nutr ; 24(14): 4377-4386, 2021 10.
Article in English | MEDLINE | ID: covidwho-1340967

ABSTRACT

OBJECTIVE: To explore women's perceptions of changes in specific food habits at home, specifically the food budget and shopping, and food preparation, during the COVID-19 period. DESIGN: Non-probabilistic, exploratory study. Participants completed an online self-administered questionnaire. Perceptions of food habit changes were measured on a five-point Likert scale (strongly disagree to strongly agree). Data analysis was conducted in STATA v16.0. SETTING: Chile. PARTICIPANTS: Adult women between 25 and 65 years old (n 2047). RESULTS: Of the participants, 72 % were responsible for cooking, 69 % for buying food and 85 % for child care. Difficulties in organising and doing food budget works were observed in groups with a lower educational level, lower income and single mothers with children. Younger participants, dependent workers, women from biparental families with children and those in mandatory quarantine perceived more changes in their food shopping and budget management tasks. Participants more educated, with higher income and non-mandatory quarantine perceived to cook and eat healthier. Older participants perceived minor changes in their food preparation tasks at home; in contrast, more educated women and women from biparental families with children perceived more changes. If women were in charge of the kids or grocery shopping, more food environment changes were noticed. CONCLUSIONS: Women perceived changes in their food environments. Some of these changes are perceived worse in the more vulnerable population. COVID-19 presents a challenge for the food system and gender perspectives. This information should be considered in the design of food-related interventions.


Subject(s)
COVID-19 , Pandemics , Adult , Aged , Chile/epidemiology , Female , Humans , Middle Aged , Perception , SARS-CoV-2
11.
Int J Environ Res Public Health ; 18(14)2021 07 16.
Article in English | MEDLINE | ID: covidwho-1314651

ABSTRACT

BACKGROUND: Teachers worldwide had to reinvent their work routine according to teleworking during the COVID-19 pandemic, a work format that negatively impacts individuals' physical and mental health. This study evaluates the association between work hours, work-family balance and quality of life (QoL) among teachers during the Chilean health emergency of the COVID-19 pandemic. Teachers from across Chile were contacted via email and social media to answer an online survey. QoL was evaluated via the SF-36 questionnaire, work hours and work-family balance in the pandemic. A total of 336 teachers from across Chile participated in this study. Teachers had a low QoL score, associated with age (p < 0.05). Teachers who were ≤44 showed lower deterioration risks in the Physical Component Summary (OR: 0.54) than the ≥45-year-old age group; simultaneously, the younger group (≤44 years) had a greater risk (OR: 2.46) of deterioration in the Mental Component Summary than teachers over 45 years. A total of 78.7% of teachers reported having increased their work hours during the COVID-19 pandemic due to teleworking and 86% indicated negative effects on their work-family balance. Pandemic work hours and negative work-family balance increase the risk of reducing the Mental Component Summary (OR: 1.902; OR: 3.996, respectively). Teachers presented low median QoL scores, especially in the Mental Component Summary, suggesting that it would be beneficial to promote a better workload distribution for teachers in emergency contexts, considering the adverse effects of teleworking.


Subject(s)
COVID-19 , Quality of Life , Adult , Chile/epidemiology , Humans , Middle Aged , Pandemics , SARS-CoV-2 , Teleworking
12.
Int J Environ Res Public Health ; 18(14)2021 07 14.
Article in English | MEDLINE | ID: covidwho-1314639

ABSTRACT

Although vaccination is carried out worldwide, the vaccination rate varies greatly. As of 24 May 2021, in some countries, the proportion of the population fully vaccinated against COVID-19 has exceeded 50%, but in many countries, this proportion is still very low, less than 1%. This article aims to explore the impact of vaccination on the spread of the COVID-19 pandemic. As the herd immunity of almost all countries in the world has not been reached, several countries were selected as sample cases by employing the following criteria: more than 60 vaccine doses per 100 people and a population of more than one million people. In the end, a total of eight countries/regions were selected, including Israel, the UAE, Chile, the United Kingdom, the United States, Hungary, and Qatar. The results find that vaccination has a major impact on reducing infection rates in all countries. However, the infection rate after vaccination showed two trends. One is an inverted U-shaped trend, and the other is an L-shaped trend. For those countries with an inverted U-shaped trend, the infection rate begins to decline when the vaccination rate reaches 1.46-50.91 doses per 100 people.


Subject(s)
COVID-19 , Immunity, Herd , Chile/epidemiology , Humans , Hungary , Israel/epidemiology , Pandemics , Qatar , SARS-CoV-2 , United Kingdom , Vaccination
13.
Am J Respir Crit Care Med ; 204(1): 34-43, 2021 07 01.
Article in English | MEDLINE | ID: covidwho-1311194

ABSTRACT

Rationale: The role of and needs for extracorporeal membrane oxygenation (ECMO) at a population level during the coronavirus disease (COVID-19) pandemic have not been completely established. Objectives: To identify the cumulative incidence of ECMO use in the first pandemic wave and to describe the Nationwide Chilean cohort of ECMO-supported patients with COVID-19. Methods: We conducted a population-based study from March 3 to August 31, 2020, using linked data from national agencies. The cumulative incidence of ECMO use and mortality risk of ECMO-supported patients were calculated and age standardized. In addition, a retrospective cohort analysis was performed. Outcomes were 90-day mortality after ECMO initiation, ECMO-associated complications, and hospital length of stay. Cox regression models were used to explore risk factors for mortality in a time-to-event analysis. Measurements and Main Results: Ninety-four patients with COVID-19 were supported with ECMO (0.42 per population of 100,000, 14.89 per 100,000 positive cases, and 1.2% of intubated patients with COVID-19); 85 were included in the cohort analysis, and the median age was 48 (interquartile range [IQR], 41-55) years, 83.5% were men, and 42.4% had obesity. The median number of pre-ECMO intubation days was 4 (IQR, 2-7), the median PaO2/FiO2 ratio was 86.8 (IQR, 64-99) mm Hg, 91.8% of patients were prone positioned, and 14 patients had refractory respiratory acidosis. Main complications were infections (70.6%), bleeding (38.8%), and thromboembolism (22.4%); 52 patients were discharged home, and 33 died. The hospital length of stay was a median of 50 (IQR, 24-69) days. Lower respiratory system compliance and higher driving pressure before ECMO initiation were associated with increased mortality. A duration of pre-ECMO intubation ≥10 days was not associated with mortality. Conclusions: Documenting nationwide ECMO needs may help in planning ECMO provision for future COVID-19 pandemic waves. The 90-day mortality of the Chilean cohort of ECMO-supported patients with COVID-19 (38.8%) is comparable to that of previous reports.


Subject(s)
COVID-19/therapy , Extracorporeal Membrane Oxygenation/statistics & numerical data , Respiratory Distress Syndrome/therapy , Adult , Aged , COVID-19/complications , COVID-19/diagnosis , COVID-19/epidemiology , Chile/epidemiology , Female , Humans , Incidence , Male , Middle Aged , Needs Assessment , Respiratory Distress Syndrome/diagnosis , Respiratory Distress Syndrome/epidemiology , Respiratory Distress Syndrome/virology , Retrospective Studies , Severity of Illness Index , Treatment Outcome
14.
Int J Environ Res Public Health ; 18(14)2021 07 11.
Article in English | MEDLINE | ID: covidwho-1308348

ABSTRACT

BACKGROUND: Several countries have documented the relationship between long-term exposure to air pollutants and epidemiological indicators of the COVID-19 pandemic, such as incidence and mortality. This study aims to explore the association between air pollutants, such as PM2.5 and PM10, and the incidence and mortality rates of COVID-19 during 2020. METHODS: The incidence and mortality rates were estimated using the COVID-19 cases and deaths from the Chilean Ministry of Science, and the population size was obtained from the Chilean Institute of Statistics. A chemistry transport model was used to estimate the annual mean surface concentration of PM2.5 and PM10 in a period before the current pandemic. Negative binomial regressions were used to associate the epidemiological information with pollutant concentrations while considering demographic and social confounders. RESULTS: For each microgram per cubic meter, the incidence rate increased by 1.3% regarding PM2.5 and 0.9% regarding PM10. There was no statistically significant relationship between the COVID-19 mortality rate and PM2.5 or PM10. CONCLUSIONS: The adjusted regression models showed that the COVID-19 incidence rate was significantly associated with chronic exposure to PM2.5 and PM10, even after adjusting for other variables.


Subject(s)
Air Pollutants , Air Pollution , COVID-19 , Air Pollutants/analysis , Air Pollution/adverse effects , Air Pollution/analysis , Chile/epidemiology , Environmental Exposure/adverse effects , Environmental Exposure/analysis , Humans , Incidence , Mortality , Pandemics , Particulate Matter/analysis , SARS-CoV-2
15.
N Engl J Med ; 385(10): 875-884, 2021 09 02.
Article in English | MEDLINE | ID: covidwho-1298875

ABSTRACT

BACKGROUND: Mass vaccination campaigns to prevent coronavirus disease 2019 (Covid-19) are occurring in many countries; estimates of vaccine effectiveness are urgently needed to support decision making. A countrywide mass vaccination campaign with the use of an inactivated severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccine (CoronaVac) was conducted in Chile starting on February 2, 2021. METHODS: We used a prospective national cohort, including participants 16 years of age or older who were affiliated with the public national health care system, to assess the effectiveness of the inactivated SARS-CoV-2 vaccine with regard to preventing Covid-19 and related hospitalization, admission to the intensive care unit (ICU), and death. We estimated hazard ratios using the extension of the Cox proportional-hazards model, accounting for time-varying vaccination status. We estimated the change in the hazard ratio associated with partial immunization (≥14 days after receipt of the first dose and before receipt of the second dose) and full immunization (≥14 days after receipt of the second dose). Vaccine effectiveness was estimated with adjustment for individual demographic and clinical characteristics. RESULTS: The study was conducted from February 2 through May 1, 2021, and the cohort included approximately 10.2 million persons. Among persons who were fully immunized, the adjusted vaccine effectiveness was 65.9% (95% confidence interval [CI], 65.2 to 66.6) for the prevention of Covid-19 and 87.5% (95% CI, 86.7 to 88.2) for the prevention of hospitalization, 90.3% (95% CI, 89.1 to 91.4) for the prevention of ICU admission, and 86.3% (95% CI, 84.5 to 87.9) for the prevention of Covid-19-related death. CONCLUSIONS: Our results suggest that the inactivated SARS-CoV-2 vaccine effectively prevented Covid-19, including severe disease and death, a finding that is consistent with results of phase 2 trials of the vaccine. (Funded by Agencia Nacional de Investigación y Desarrollo and others.).


Subject(s)
COVID-19 Vaccines/immunology , COVID-19/prevention & control , Immunogenicity, Vaccine , Mass Vaccination , Adolescent , Adult , Aged , Aged, 80 and over , COVID-19/epidemiology , COVID-19/mortality , Chile/epidemiology , Female , Hospitalization/statistics & numerical data , Humans , Incidence , Intensive Care Units , Male , Middle Aged , Patient Acuity , Prospective Studies , Treatment Outcome , Vaccines, Inactivated , Young Adult
16.
Int J Environ Res Public Health ; 18(13)2021 06 26.
Article in English | MEDLINE | ID: covidwho-1288863

ABSTRACT

The population's behavioral responses to containment and precautionary measures during the COVID-19 pandemic have played a fundamental role in controlling the contagion. A comparative analysis of precautionary behaviors in the region was carried out. A total of 1184 people from Mexico, Colombia, Chile, Cuba, and Guatemala participated through an online survey containing a questionnaire on sociodemographic factors, precautionary behaviors, information about COVID-19, concerns, maintenance of confinement, and medical symptoms associated with COVID-19. Cubans reported the highest scores for information about COVID-19. Colombians reported less frequent usage of precautionary measures (e.g., use of masks), but greater adherence to confinement recommendations in general, in contrast to the low levels of these behaviors in Guatemalans. Chileans reported greater pandemic-related concerns and the highest number of medical symptoms associated with COVID-19. These findings allow a partial characterization of the Latin American population's responses during the second and third phases of the COVID-19 pandemic and highlight the importance of designing and managing public health policies according to the circumstances of each population when facing pandemics.


Subject(s)
COVID-19 , Pandemics , Chile/epidemiology , Colombia , Guatemala/epidemiology , Humans , Latin America/epidemiology , Mexico , SARS-CoV-2
18.
J Stroke Cerebrovasc Dis ; 30(11): 105953, 2021 Nov.
Article in English | MEDLINE | ID: covidwho-1275544

ABSTRACT

Background and purpose; Chile has been one of the most affected countries by the COVID-19 pandemic, with one of the highest case rates per population. This has affected the epidemiological behaviour of various pathologies. We analyze the impact of the pandemic on the number of admissions due to stroke, its severity and mortality in Santiago, Chile. METHODS: a multicenter observational study based on the records of the 3 hospitals of the South East health service in Santiago, Chile. We recorded the number of patients admitted for ischemic stroke between 01 January 2020 and 30 June 2020. We grouped the cases into two periods, pre-pandemic and pandemic, according to the setting of the state of emergency in Chile. RESULTS: 431 patients were admitted with ischemic stroke during the study period. There was a non-significant decrease in weekly admissions (17 vs 15 patients per week). No differences were observed in the proportion of patients with medical treatment (p = 0.810), IVT (p = 0.638), EVT (p = 0.503) or IVT + EVT (p = 0.501). There was a statistically significant increase in the NIHSS on admission (7.23 vs 8.78, p = 0.009) and mortality (5.2% vs 12.4%, p = 0.012). In a multivariate analysis the NIHSS on admission was associated with the increased mortality (RR 1.11, CI 1.04-1.19, p = 0.003). CONCLUSION: We found an increase in the severity of ischemic stroke on admission and in-hospital mortality during the pandemic period. The main factor to increase in-hospital mortality was the NIHSS on admission.


Subject(s)
COVID-19/mortality , Ischemic Stroke/mortality , Aged , Aged, 80 and over , COVID-19/diagnosis , Chile/epidemiology , Disability Evaluation , Female , Hospital Mortality , Humans , Ischemic Stroke/diagnosis , Male , Middle Aged , Patient Admission , Prognosis , Risk Assessment , Risk Factors , Severity of Illness Index , Time Factors
19.
PLoS One ; 16(6): e0252938, 2021.
Article in English | MEDLINE | ID: covidwho-1278182

ABSTRACT

This paper develops a methodology for the assessment of the short-run effects of lockdown policies on economic activity. The methodology combines labor market data with simulation of an agent-based model. We apply our methodology to the Santiago Metropolitan Region, Chile. We recover the model parameters from observed data, taking into account the recurring policy adjustments that characterized the study window. The model is used to build counterfactual scenarios. We estimate an 8 percent output loss in the first 5 months of the pandemic from the policy that was put in place, achieving a 56 percent reduction in the total number of infections. During this period, with an output loss to 10.5 percent of GDP, the infection rate would have decreased 92 percent, significantly delaying the spread of COVID and spike in infections. Our methodology applied to real data provided results that could be valuable in guiding policies in other lockdown situations in times of disaster, pandemics or social upheaval.


Subject(s)
COVID-19/psychology , Communicable Disease Control/legislation & jurisprudence , Economic Development , Policy , Quarantine/economics , SARS-CoV-2/isolation & purification , COVID-19/epidemiology , COVID-19/prevention & control , Chile/epidemiology , Government , Humans
20.
BMC Infect Dis ; 21(1): 478, 2021 May 26.
Article in English | MEDLINE | ID: covidwho-1244912

ABSTRACT

BACKGROUND: Healthcare workers (HCWs) are at high risk of exposure to SARS-CoV-2. Cross-sectional studies have provided variable rates of seroprevalence in HCWs. Longitudinal assessments of the serological response to Covid-19 among HCWs are crucial to understanding the risk of infection and changes in antibody titers over time. We aimed to investigate seroprevalence and risk factors associated with seroconversion in a prospective cohort of HCWs during the peak of the first wave of the Covid-19 pandemic. METHODS: We conducted a longitudinal study among 446 front-line HCWsin a tertiary-care hospital in Chile from April to July 2020. IgG was determined monthly using two different ELISAs in serum samples of HCWs, during the three-month period. In each visit, demographic data, symptoms, risk factors, and exposure risks were also assessed. RESULTS: The overall seroprevalence at the end of the study period was 24% (95% CI20.2-28.3), with 43% of seropositive HCWs reporting no prior symptoms. Seroconversion rates significantly differed over the study period, from 2.1% to as high as 8.8% at the peak of the epidemic. There were no statistically significant differences observed between HCWs in direct clinical care of patients with Covid-19 and those working in low risk areas. Antibody titers appeared to wane over time. CONCLUSIONS: HCWs were severely affected with a high rate of seroconversion that appeared to mirror the local epidemiological situation. A significant amount of participants underwent an asymptomatic infection, highlighting the need for improved surveillance policies. Antibody titers appear to wane over time; further studies to understand this finding's impact on the risk of reinfection are warranted.


Subject(s)
Antibodies, Viral/blood , COVID-19 Serological Testing , COVID-19/immunology , Health Personnel/statistics & numerical data , Immunoglobulin G/blood , SARS-CoV-2/immunology , Seroconversion , Adult , Aged , COVID-19/diagnosis , COVID-19/epidemiology , Chile/epidemiology , Cohort Studies , Enzyme-Linked Immunosorbent Assay/methods , Female , Humans , Longitudinal Studies , Male , Middle Aged , Prospective Studies , Seroepidemiologic Studies , Tertiary Care Centers
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