ABSTRACT
Abstract Objective: Epidemiological Characterization of COVID-19 cases presented in the ISSET in the period from March 1st2020 to January 18th2021. Material and method: Descriptive, cross-sectional and retrospective study at the Social Security Institute of the State of Tabasco from March 1st2020 to January 18th2021. Data collected from the Respiratory Disease Surveillance System Platform. Numerical data were expressed as count proportions in percentages for categorical data. Incidence and case fatality rates were calculated. Results: 4,283 positive cases were registered for SARS-CoV-2, by rt- PCR, with the highest incidence of cases in women with 51.04% of cases aged 50 to 54 years, and 21% corresponding to health personnel entitled. The mortality rate was higher in men aged 60 to 64 years, associated with comorbidities, such as hypertension, diabetes, and obesity. Conclusion: The evolution of the COVID-19 pandemic has increased exponentially since it begin, health personnel have been directly affected. The mortality it presents is high, concentrating mainly in those over 60 years of age and with associated chronic non-communicable diseases, where it has atypical manifestations and catastrophic effects.
Resumen Objetivo: Caracterización epidemiológica de los casos de COVID-19 presentados en el ISSET en el período del 1 de marzo de 2020 al 18 de enero de 2021. Material y método: Estudio descriptivo, transversal y retrospectivo en el Instituto de Seguridad Social del Estado de Tabasco del 1 de marzo de 2020 al 18 de enero de 2021. Datos recopilados de la plataforma del sistema de vigilancia de enfermedades respiratorias. Los datos numéricos se expresaron como proporciones de recuento en porcentajes para los datos categóricos. Se calcularon las tasas de incidencia y letalidad. Resultados: Se registraron 4.283 casos positivos para SARS-CoV-2, por rt-PCR, con mayor incidencia de casos en mujeres con 51,04% de casos de 50 a 54 años, y 21% correspondiente al personal de salud titulado. La tasa de mortalidad fue mayor en hombres de 60 a 64 años, asociada a comorbilidades, como hipertensión, diabetes y obesidad. Conclusión: La evolución de la pandemia COVID-19 ha aumentado exponencialmente desde que comenzó, el personal de salud se ha visto afectado directamente. La mortalidad que presenta es alta, concentrándose principalmente en los mayores de 60 años y con enfermedades crónicas no transmisibles asociadas, donde tiene manifestaciones atípicas y efectos catastróficos.
ABSTRACT
INTRODUCTION: Severe acute respiratory syndrome-related coronavirus (SARS-CoV-2) infection is characterised by a viral phase and a severe pro-inflammatory phase. The inhibition of the JAK/STAT pathway limits the pro-inflammatory state in moderate to severe COVID-19. METHODOLOGY: We analysed the data obtained by an observational cohort of patients with SARS-CoV-2 pneumonia treated with ruxolitinib in 22 hospitals of Mexico. The applied dose was determined based on physician's criteria. The benefit of ruxolitinib was evaluated using the 8-points ordinal scale developed by the NIH in the ACTT1 trial. Duration of hospital stay, changes in pro-inflammatory laboratory values, mortality, and toxicity were also measured. RESULTS: A total of 287 patients were reported at 22 sites in Mexico from March to June 2020; 80.8% received ruxolitinib 5 mg BID and 19.16% received ruxolitinib 10 mg BID plus standard of care. At beginning of treatment, 223 patients were on oxygen support and 59 on invasive ventilation. The percentage of patients on invasive ventilation was 53% in the 10 mg and 13% in the 5 mg cohort. A statistically significant improvement measured as a reduction by 2 points on the 8-point ordinal scale was described (baseline 5.39 ± 0.93, final 3.67± 2.98, p = 0.0001). There were 74 deaths. Serious adverse events were presented in 6.9% of the patients. CONCLUSIONS: Ruxolitinib appears to be safe in COVID-19 patients, with clinical benefits observed in terms of decrease in the 8-point ordinal scale and pro-inflammatory state. Further studies must be done to ensure efficacy against mortality.
